Presentation
Dyspnea and dry cough.
Patient Data
Bilateral symmetrical lower lobe predominant ground glass attenuation with minimal fine reticulations and mild traction bronchiectasis.
No honeycombing.
Changes are relatively sparing the subpleural space.
Features are most likely suggesting NSIP pattern.
Coronal image demonstrates the basal predominance (arrows).
Axial images demonstrate sparing of the immediate subpleural space (arrows).
Case Discussion
The patient is a known case of Sjogren syndrome. Thoracic manifestations of Sjögren syndrome vary, the most common is non-specific interstitial pneumonia (NSIP).
NSIP is less common than UIP and tends to present in a younger patient population (peak 40 to 50 years). In general, the prognosis of patients with NSIP is better than that of UIP. The distribution of NSIP is similar to that of UIP, being subpleural and basilar predominant. However, a peripheral concentric distribution of abnormalities with relative sparing of the immediate subpleural space is highly predictive of NSIP.