Lymphocytic interstitial pneumonia in Sjögren syndrome
55 year old female with known Sjögren syndrome. Present with longstanding history of dry cough.
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High resolution axial images of the chest demonstrate occasional thin walled cysts (red arrows) measuring up to 1.5 cm in diameter. Note the cysts are peribronchovascular in location and accompanied vessels can often be seen on the walls of the cyst. There are also occasional focal areas of nodular ground glass opacities (blue arrows) and nodules (green arrow). Coronal minimal intensity projection image demonstrate the basal predominance distribution of disease.
Lymphocytic interstitial pneumonia in Sjögren syndrome is characterized by lymphocytic infiltration of the small airway or alveolar septa resulting in CT apperance of centrilobular nodules and peribronchiolar ground glass opacities which eventually evolve to form thin walled cysts measuring 5-30 mm. Presence of cysts are useful in differentiating lymphocytic interstitial pneumonia from lymphoma which demonstrate consolidation, larger nodules, or associated pleural effusion.