Department of Respiratory medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-Higashi, Kanazawa-ku, Yokohama city, Kanagawa, 236-0051, Japan.
Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
BMC Pulm Med. 2020 Oct 23;20(1):277. doi: 10.1186/s12890-020-01318-0.
Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by deteriorated exocrine gland function with associated lymphocytic infiltration. However, there are few pathological studies on bronchial glands in SS. In this study, we aimed to clarify pathological features of bronchial glands in SS.
We retrospectively evaluated infiltration of lymphocytes in the bronchial glands incidentally collected by transbronchial lung cryobiopsy (TBLC), which were performed for the diagnosis of diffuse lung diseases. The degrees of lymphocyte infiltration in the bronchial glands were classified into four grades (grade 0-3). We compared the degrees of infiltration of SS with those of other diffuse lung diseases.
TBLC for diagnosis of diffuse lung diseases were performed on 432 cases during the study period. The samples of 50 cases included bronchial glands. Of those, 20 cases were excluded due to insufficient size or influence of therapy. The remaining 30 cases included 17 of idiopathic interstitial pneumonias, 5 of chronic hypersensitivity pneumonia, 6 of connective tissue disease (SS; n = 4, systemic sclerosis; n = 1, dermatomyositis; n = 1) and 2 of other diseases. In SS, infiltration of lymphocytes was observed in all cases; grade 1 in one, grade 2 in one, and grade 3 in two cases. In contrast, 11 of 26 in other diseases showed no lymphocytes infiltration, with the remaining 15 of grade 1 infiltration. Grade 2 or more infiltration were found only in SS but not in other diseases.
Our results suggested that high-grade lymphocytic infiltration of bronchial glands is a distinct characteristics in SS.
干燥综合征(SS)是一种系统性自身免疫性疾病,其特征为外分泌腺功能恶化伴淋巴细胞浸润。然而,SS 患者支气管腺的病理研究较少。本研究旨在阐明 SS 患者支气管腺的病理特征。
我们回顾性评估了经支气管肺冷冻活检(TBLC)偶然采集的支气管腺中淋巴细胞的浸润程度,TBLC 用于诊断弥漫性肺疾病。将支气管腺内淋巴细胞的浸润程度分为 4 个等级(0-3 级)。我们比较了 SS 和其他弥漫性肺疾病的浸润程度。
在研究期间,对 432 例弥漫性肺疾病患者进行了 TBLC。其中 50 例的样本中包含支气管腺。由于组织块太小或受治疗影响,20 例被排除。剩余的 30 例中包括特发性间质性肺炎 17 例,慢性过敏性肺炎 5 例,结缔组织病(SS4 例,系统性硬化症 1 例,皮肌炎 1 例)6 例和其他疾病 2 例。在 SS 中,所有病例均观察到淋巴细胞浸润,1 例为 1 级,1 例为 2 级,2 例为 3 级。相比之下,其他疾病中 26 例无淋巴细胞浸润,15 例为 1 级浸润。仅在 SS 中发现 2 级或更高级别的浸润,而在其他疾病中则没有。
我们的结果表明,支气管腺内高水平的淋巴细胞浸润是 SS 的一个显著特征。