Sowa Terumasa, Komatsu Teruya, Fujinaga Takuji, Kato Tatsuo
Department of General Thoracic Surgery, Nagara medical center, National Hospital Organization, Gifu, Gifu, Japan.
Ann Thorac Cardiovasc Surg. 2013;19(3):247-9. doi: 10.5761/atcs.cr.12.01890. Epub 2012 Aug 20.
Patients with Sjögren's syndrome frequently have pulmonary involvement, but the involvement of nodular pulmonary lesions, including pulmonary amyloidosis, is rare. Most cases of pulmonary amyloidosis involve multiple nodules; solitary pulmonary nodular amyloidosis, as an associated condition of Sjögren's syndrome, is very rare.In our report, we present the case of an 80-year-old female with Sjögren's syndrome who was incidentally found to have a small solitary pulmonary nodule. The nodule showed high fluorodeoxyglucose uptake and contained areas of calcification. Because the probability that the nodular lesion was malignant could not be excluded, the tumor was excised using a thoracoscopic procedure; the final diagnosis was pulmonary nodular amyloidosis. Although most cases of pulmonary amyloidosis involve multiple nodules, amyloidosis should be considered in the differential diagnosis for a solitary pulmonary nodule in patients with Sjögren's syndrome.
干燥综合征患者常伴有肺部受累，但包括肺淀粉样变性在内的结节性肺部病变较为罕见。大多数肺淀粉样变性病例累及多个结节；作为干燥综合征的相关病症，孤立性肺结节淀粉样变性非常罕见。在我们的报告中，我们介绍了一例80岁患有干燥综合征的女性患者，她偶然发现有一个小的孤立性肺结节。该结节显示氟脱氧葡萄糖摄取高且含有钙化区域。由于不能排除结节性病变为恶性的可能性，遂采用胸腔镜手术切除肿瘤；最终诊断为肺结节淀粉样变性。虽然大多数肺淀粉样变性病例累及多个结节，但对于干燥综合征患者的孤立性肺结节，在鉴别诊断中应考虑淀粉样变性。
