PMC5901953_01
Chest radiograph and CT findings in a 72-year-old woman with Sjogren syndrome and pulmonary amyloidosis. (a) Chest radiograph shows infiltrates in the right lower lung field and ground-glass shadows in the bilateral lower lung fields. Chest CT shows (b, c) multiple cystic lung shadows in the bilateral upper lobes, (d) infiltrates in the right middle lobe and a nodular shadow in the left lower lobe, and (e) ground-glass shadows in the bilateral lower lobes. CT, computed tomography.
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C, and the absence of crackles on auscultation. Chest radiography showed infiltrates on the right lower lung field, and chest CT showed multiple infiltrates and cystic lesions in the bilateral lung (Figure 1).
Pathologic findings of the surgical lung biopsy in a 72-year-old woman with Sjogren syndrome and pulmonary amyloidosis. (a) There is a homogeneous eosinophilic material in the vascular area (hematoxylin and eosin stain, x100), which (b) was positive on Congo red stain (x100). (c) Polarizing microscopy shows apple green birefringence (x100). (d) The immunohistochemical staining with AA amyloid (x100) was negative. (e) The immunohistochemical staining with AL-kappa amyloid (x100) was positively stained. (f) There is infiltration of inflammatory cells in the peribronchial areas (hematoxylin and eosin stain, x100).
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Surveillance chest computed tomography in a 72-year-old woman with Sjogren syndrome and pulmonary amyloidosis after 6 years of follow-up. The cystic lung lesions gradually increased in size and number after 6 years. (a-c) The right lower lobe and (d-f) the left upper and lower lobes are shown. (a) and (d) are images taken upon the time of diagnosis, (b) and (e) are images taken after 3 years, and (c) and (f) are images taken after 6 years.
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After 6 years, the cystic lung lesions gradually enlarged and increased in number (Figure 3), but she remained to have no respiratory symptoms, no decrease in FEV1 (1.18 L), and no findings of lymphoproliferative disorder.