{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:56:48Z","timestamp":1774591008941,"version":"3.50.1"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Immunoglobulin G4\u2010related disease (IgG4\u2010RD) is a rare systemic fibroinflammatory condition that may affect virtually any organ, including the lungs. Thoracic involvement often occurs with non\u2010specific imaging findings and requires histopathological confirmation. We present the case of a 71\u2010year\u2010old man with a history of T\u2010cell large granular lymphocytic leukaemia and MGUS, who presented with smoking\u2010related interstitial lung disease on high\u2010resolution chest computed tomography (CT) and left lower lobe (LLL) consolidation. Positron emission tomography (PET)\/CT revealed hypermetabolic activity in lung consolidations and mediastinal and diaphragmatic lymph nodes. A right diaphragmatic lymph node biopsy showed increased IgG4\u2010positive plasma cells (IgG4\/IgG &gt;\u200940%). Subsequent transbronchial biopsies confirmed the presence of dense lymphoplasmacytic infiltrates, fibrosclerosis and IgG4\u2010positive plasma cells in lung tissue. Given the patient's diabetes, rituximab (RTX) was chosen over corticosteroids. RTX, consisting of four weekly infusions, led to significant clinical improvement and complete metabolic response on follow\u2010up PET\/CT. Reporting this case, we would like to emphasise the importance of considering IgG4\u2010RD in the differential diagnosis of atypical thoracic infiltrates and highlight the role of RTX as an effective therapeutic option in patients for whom corticosteroids are contraindicated.<\/jats:p>","DOI":"10.1002\/rcr2.70538","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:07:07Z","timestamp":1773648427000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>IgG4<\/scp>\n                    \u2010Related Lung Disease in a Former Smoker: A Challenging Diagnosis"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0812-1295","authenticated-orcid":false,"given":"Serena","family":"Bellani","sequence":"first","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Pezzuto","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Science, and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Garbin","sequence":"additional","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3368-2608","authenticated-orcid":false,"given":"Beatrice","family":"Scapolan","sequence":"additional","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Santomartino","sequence":"additional","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiorella","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Science, and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Balestro","sequence":"additional","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-6984","authenticated-orcid":false,"given":"Nicol","family":"Bernardinello","sequence":"additional","affiliation":[{"name":"Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1104650"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60720-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41120"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165\u2010011\u20100571\u2010z"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2020.1859710"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00025211"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-025-04213-3"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.50.4413"}],"container-title":["Respirology Case 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