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Video

Laryngology/Broncho-Esophagology

(A719) IgG4-Related Disease of the Glottis: A Rare Primary Presentation of IgG4-RD

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Justina Varghese, BA, MS-3

    Medical Student
    Hackensack Meridian School of Medicine
    Farmingville, New York, United States

    • Co-Author(s)

  • SB

    Shreeya Bahethi, BS, MS-2

    Medical Student
    Hackensack Meridian School of Medicine
    Montclair, New Jersey, United States

  • BH

    Bethany Ho, MD

    Hackensack Meridian School of Medicine, United States

  • AS

    Aaron Sohn, MD

    Staff Pathologist
    Department of Pathology, Hackensack University Medical Center
    Palisades Park, New Jersey, United States

    • Senior Author(s)

  • BB

    Brian Benson, MD

    Department of Otolaryngology–Head and Neck Surgery, Hackensack University Medical Center, United States

Disclosure(s):
Justina Varghese, BA: No relevant relationships to disclose.
Shreeya Bahethi, Other: No relevant relationships to disclose.
Aaron Sohn, MD: No relevant relationships to disclose.


Introduction: IgG4-related disease (IgG4-RD) is a chronic autoimmune disease characterized by fibrotic inflammatory lesions throughout the body, rarely involving the larynx. We report an unusual case of primary glottic IgG4-related disease of the larynx.

Methods: The study is a case report and literature review conducted at a single institution between November 2023-April 2024 of a patient with IgG4-related disease of the glottis. We describe a 56 year-old man with a 75-pack-year smoking history, T2DM, and multiple recent intubations for cardiac surgeries who presented with one year of worsening dysphonia and bilateral glottic mass lesions. Bilateral glottic polypoid masses were noted on flexible laryngoscopy. Excisional biopsy of the left vocal lesion revealed lymphoplasmacytic infiltrates without dysplasia or carcinoma present. IgG4 immunostaining revealed >200 polyclonal plasma cells per high power field, with the ratio of IgG4+ plasma cells: IgG+ plasma cells of 45%.

Results: Histology findings confirmed diagnosis of IgG4-RD. PET scan revealed no other organ involvement. Post-operatively, a twelve-week medium dose prednisone taper achieved improvement of vocal symptoms, with residual mass lesion on right glottis not significantly impacting vocal quality.

Conclusions: IgG4-RD that presents as an isolated vocal fold mass without additional organ involvement can easily be misidentified as more common vocal fold lesions, thus, prompt tissue biopsy and referral to rheumatologist for ongoing medical management is critical.