Takeda T, Sakai I, Taneichi K, Shibaki H
Department of Internal Medicine, Kitami Red Cross Hospital, Hokkaido.
Ryumachi. 1996 Jun;36(3):565-9.
A 73-year-old woman was admitted to our hospital in January 1995 because of dry cough and dyspnea. A diagnosis of primary Sjögren's syndrome with distal renal tubular acidosis and Hashimoto's disease had been made in 1984. Dry cough developed and a chest X-ray showed bilateral reticulo-nodular shadows in the lower lung field in 1992. Her symptoms had gradually became more severe and the reticulo-nodular shadows on her chest X-ray had spread to both upper lung fields. We performed transbronchial lung biopsy. Biopsy specimens showed lymphocytic infiltration of the aleveolar walls. These lymphocytes were almost CD3-positive and CD19-negative in immunohistopathological studies. CD4-positive cells and CD8-positive cells were present in almost equal numbers. A diagnosis of lymphocytic interstitial pneumonia (LIP) associated with Sjögren's syndrome was made. The patient was treated with prednisolone, 40 mg daily. Her dry cough and dyspnea improved slightly but her chest X-ray remained unchanged. We suggest that immunohistopathological analysis of biopsy specimens may show a difference between lymphocytic infiltration of labial salivary glands and of the lung.
一名73岁女性于1995年1月因干咳和呼吸困难入院。1984年诊断为原发性干燥综合征合并远端肾小管酸中毒和桥本氏病。1992年出现干咳,胸部X线显示双下肺野网状结节影。她的症状逐渐加重,胸部X线的网状结节影已蔓延至双上肺野。我们进行了经支气管肺活检。活检标本显示肺泡壁淋巴细胞浸润。免疫组织病理学研究显示,这些淋巴细胞几乎CD3阳性而CD19阴性。CD4阳性细胞和CD8阳性细胞数量几乎相等。诊断为与干燥综合征相关的淋巴细胞间质性肺炎(LIP)。患者接受泼尼松龙治疗,每日40mg。她的干咳和呼吸困难略有改善,但胸部X线表现无变化。我们认为活检标本的免疫组织病理学分析可能显示唇唾液腺和肺的淋巴细胞浸润存在差异。