Yamamoto Michiko, Kubota Masaru, Nagashima Yujiro, Katono Ken, Wada Mayuko, Masuda Noriyuki
Respiratory Medicine, School of Medicine, Kitasato University.
Nihon Kokyuki Gakkai Zasshi. 2011 Nov;49(11):843-7.
A 68-year-old woman was admitted to our institution's respiratory section because of dyspnea on effort in January, 2007. She had previously received a diagnosis of Sjögren's syndrome because of dryness in her eyes in 1991. Chest radiography and chest CT in 2001 revealed diffuse multiple cystic lesions in both lungs which had progressed gradually for 6 years. Biopsy specimens obtained by video-assisted thoracoscopy showed lymphoid hyperplasia with follicular bronchiolitis and lymphocytic alveolitis. Narrowing of the small airways and obstructive lung disease with multiple bullae were observed and we suspected them to be related to peribronchiolar lymphocytic infiltration. These were lung involvements associated with Sjögren's syndrome. The patient's cystic lesions gradually worsened despite the administration of corticosteroid and cyclophosphamide. Cystic lesions in Sjögren's syndrome may be a treatment-resistant finding.
一名68岁女性因2007年1月活动时出现呼吸困难入住我院呼吸科。她曾于1991年因眼干被诊断为干燥综合征。2001年胸部X线和胸部CT显示双肺弥漫性多发囊性病变,这些病变已逐渐进展6年。经电视辅助胸腔镜获取的活检标本显示淋巴样增生伴滤泡性细支气管炎和淋巴细胞性肺泡炎。观察到小气道狭窄和伴有多个肺大疱的阻塞性肺疾病,我们怀疑它们与细支气管周围淋巴细胞浸润有关。这些是与干燥综合征相关的肺部受累表现。尽管给予了皮质类固醇和环磷酰胺治疗,患者的囊性病变仍逐渐恶化。干燥综合征中的囊性病变可能是一种难治性表现。