Challenges in Medicine: The Odyssey of a Patient with Isolated IgG4-Related Eosinophilic Angiocentric Fibrosis Presenting as a Locally Destructive Sinonasal Mass

<div>(a) Obliterative phlebitis—20x hematoxylin and eosin (H&amp;E) stain showing cellular fibroinflammatory zone with irregular elastic remnants of larger vein; (b) storiform fibrosis—20x H&amp;E stain showing paucicellular zone of whorled and interlacing collagen bundles with residual spindle-shaped fibroblast nuclei; (c) lymphoplasmacytic infiltration—40x H&amp;E stain showing densely cellular inflammatory infiltrate with numerous plasma cells and eosinophils in a fibrous matrix; (d) immunohistochemistry shows strong positive brown chromogen decoration of IgG4-positive lymphoid cells, exceeding 50/high power field.</div>

Case Reports in Rheumatology

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Figure 2: Challenges in Medicine: The Odyssey of a Patient with Isolated IgG4-Related Eosinophilic Angiocentric Fibrosis Presenting as a Locally Destructive Sinonasal Mass 

Figure 2 | Challenges in Medicine: The Odyssey of a Patient with Isolated IgG4-Related Eosinophilic Angiocentric Fibrosis Presenting as a Locally Destructive Sinonasal Mass 