IgG4-Related Disease, the Malignancy Mimicker: Case Series from Bahrain

Figure 3

(a, b) Contrast-enhanced CT scan neck showing lobulated enhancing lesion in the deep lobe of the left parotid gland about 2.3 × 2.0 cm. Similar enhancing soft tissue thickening is seen involving adjacent left carotid space reaching up to the base of the skull. (c, d) MRI neck and brain with FLAIR images showing the same lesion in the left parotid gland and carotid space. (e) MRI brain showing involvement of the left 12th cranial nerve at the skull base. (f, g) PET CT presteroid and rituximab (July 2016) and steroid and rituximab (November 2016) showing significant resolution. (h) Proton radiotherapy. (i, j) MRI brain done in August 2017 showing extensive diffuse irregular enhancing subependymal lesions (axial views). (k, l) MRI brain done in August 2017 showing extensive diffuse irregular enhancing subependymal lesions (sagittal views). (m, n) MRI brain done in October 2017 showing significant regression of all lesions after treatment with steroid and rituximab.