{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:39:23Z","timestamp":1777927163109,"version":"3.51.4"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Nucl Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>IgG4-related disease (IgG4-RD) is a chronic fibro-inflammatory condition that can mimic malignancy due to its tumorous lesions. Marginal zone lymphoma (MZL), a low-grade B cell lymphoma, may occasionally arise in the context of chronic immune stimulation. The synchronous occurrence of IgG4-RD and MZL is rare and diagnostically challenging.<\/jats:p>\n                  <jats:p>We report the case of a 39-year-old male with right hemiplegia and aphasia, initially suspected to have a meningioma based on magnetic resonance imaging (MRI) findings. Histopathology following surgical resection revealed features consistent with IgG4-RD. Subsequently, [18F]-FDG PET\/CT ([18F]-fluorodeoxyglucose positron emission tomography\/computed tomography) demonstrated a metabolically inactive extra-axial supratentorial lesion, as well as a hypermetabolic triangular consolidation in the left lower lung lobe. Lung biopsy confirmed bronchus-associated lymphoid tissue MZL. Immunohistochemistry supported the dual diagnosis. Complementary 99mTc-iFAP SPECT\/CT (single photon emission computed tomography\/CT) demonstrated focal uptake in the central nervous system lesion but not in the pulmonary lesion. Multimodal image fusion with brain MRI facilitated precise anatomical and functional correlation.<\/jats:p>\n                  <jats:p>The coexistence of IgG4-RD and MZL raises important considerations regarding shared immunopathogenic mechanisms. Dual molecular imaging with FDG and FAPI (fibroblast activating protein inhibitor)-based radiotracers proved essential in discriminating between inflammatory and neoplastic components of disease, enabling accurate diagnosis and guiding appropriate management.<\/jats:p>\n                  <jats:p>This case highlights the value of [18F]-FDG PET\/CT and 99mTc-iFAP SPECT\/CT in the evaluation of complex systemic diseases. fibroblast activation protein\u2013targeted imaging may play a key role in the diagnostic workup of IgG4-RD and in distinguishing it from coexisting lymphoproliferative disorders.<\/jats:p>","DOI":"10.1055\/s-0045-1810609","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T22:58:15Z","timestamp":1754002695000},"page":"065-069","source":"Crossref","is-referenced-by-count":0,"title":["IgG4-Related Disease and Synchronous Marginal Zone Lymphoma Evaluated by 99mTc-iFAP SPECT\/CT and [18F]-FDG PET\/CT: A Case Report"],"prefix":"10.1055","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9057-6109","authenticated-orcid":false,"given":"Joel E.","family":"Vargas-Ahumada","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n (INCMNSZ), M\u00e9xico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Corza-Ayala","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n (INCMNSZ), M\u00e9xico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Hern\u00e1ndez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n (INCMNSZ), M\u00e9xico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myrna A.","family":"Luna-Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Radioactive Materials, Instituto Nacional de Investigaciones Nucleares (ININ), Ocoyoacac, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1056\/NEJMra1104650","article-title":"IgG4-related disease","volume":"366","author":"J H Stone","year":"2012","journal-title":"N Engl J Med"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1038\/modpathol.2012.72","article-title":"Consensus statement on the pathology of IgG4-related disease","volume":"25","author":"V Deshpande","year":"2012","journal-title":"Mod Pathol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/PAP.0b013e3181ee63ce","article-title":"IgG4-related sclerosing disease: a critical appraisal of an evolving clinicopathologic entity","volume":"17","author":"W Cheuk","year":"2010","journal-title":"Adv Anat Pathol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1053\/j.semdp.2012.08.002","article-title":"IgG4-related disease: nomenclature, clinical features, and treatment","volume":"29","author":"J H Stone","year":"2012","journal-title":"Semin Diagn Pathol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.rdc.2011.09.004","article-title":"Neoplasm mimics of rheumatologic presentations: sialadenitis, ocular masquerade syndromes, retroperitoneal fibrosis, and regional pain syndromes","volume":"37","author":"S Lipton","year":"2011","journal-title":"Rheum Dis Clin North Am"},{"key":"ref6","volume-title":"WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues","author":"S H Swerdlow","year":"2016"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s00277-021-04675-w","article-title":"Spectrum of B-cell neoplasms associated with immunoglobulin G4-related disease","volume":"101","author":"R CW Ho","year":"2022","journal-title":"Ann Hematol"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s00259-014-2961-x","article-title":"FDG PET\/CT: EANM procedure guidelines for tumour imaging: version 2.0","volume":"42","author":"R Boellaard","year":"2015","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"12","key":"ref9","first-page":"9","article-title":"FAPI PET\/CT imaging-an updated review","volume":"13","author":"K R Chandekar","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.3390\/ph16101434","article-title":"99mTc-Labeled FAPI SPECT imaging in idiopathic pulmonary fibrosis: preliminary results","volume":"16","author":"Y Liu","year":"2023","journal-title":"Pharmaceuticals (Basel)"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"4083","DOI":"10.3390\/ijms22084083","article-title":"Upregulated expression of activation-induced cytidine deaminase in ocular adnexal marginal zone lymphoma with IgG4-positive cells","volume":"22","author":"A Nishikori","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/pin.13251","article-title":"Clinical characteristics and outcomes of IgG4-positive marginal zone lymphoma: systematic scoping review","volume":"72","author":"Y Nishimura","year":"2022","journal-title":"Pathol Int"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.3390\/biomedicines12112485","article-title":"Recent updates of PET in lymphoma: FDG and beyond","volume":"12","author":"S-Y Kim","year":"2024","journal-title":"Biomedicines"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"590","DOI":"10.3390\/ph15050590","article-title":"[99mTc]Tc-iFAP radioligand for SPECT\/CT imaging of the tumor microenvironment: kinetics, radiation dosimetry, and imaging in patients","volume":"15","author":"L Coria-Dom\u00ednguez","year":"2022","journal-title":"Pharmaceuticals (Basel)"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"266","DOI":"10.2967\/jnumed.120.244723","article-title":"Fibroblast activation protein-targeted PET\/CT with 68Ga-FAPI for imaging IgG4-related disease: comparison to 18F-FDG PET\/CT","volume":"62","author":"Y Luo","year":"2021","journal-title":"J Nucl Med"}],"container-title":["World Journal of Nuclear Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1810609.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:36:38Z","timestamp":1777674998000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1810609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":15,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1810609","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1450-1147","1607-3312"],"issn-type":[{"value":"1450-1147","type":"print"},{"value":"1607-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]}}}