PMC4531674_01
Posteroanterior chest radiographs. (A) At 11 days before admission, pleural effusion is more pronounced on the right side.. (B) On admission, bibasilar infiltration, bilateral pleural effusion and cardiomegaly are showed.. (C) 12 months later, bibasilar infiltration and bilateral pleural effusion completely resoluted.
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A chest radiography showed right pleural effusion with bilateral pulmonary infiltrations (Figure 1A). A chest radiograph showed pneumonic infiltrations in both lower lung fields with pleural effusion (Figure 1B). Following this therapy, her condition significantly improved in subjective symptoms, physical signs and objective pulmonary function and radiologic findings (Figure 1C).
Sialography of parotid gland reveals multiple sized, ectatic acina without dilatation and filling defect in main duct.
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Sialography of salivary gland showed multiple-sized ectatic changes in acina without dilatation and filling defect in the main duct (Figure 2).
Hyperplasia, spongiosis and lymphocytic infiltration in the dermis with prominent exocytosis to the epidermis are evident in the excisional biopsy of the lower lip (H&E, x200).
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On biopsy finding of the lower lip, hyperkeratosis and spongiosis were seen, and lymphocytes infiltrated the dermis with exocytosis to the epidermis which was compatible with Sjogren's syndrome (Figure 3).
CT scan of the chest shows bilateral consolidation in both lower lung zones. Bilateral pleural effusion and pericardial effusion are present.
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Open lung biopsy specimen shows diffuse dense lymphoplasmacytic infiltration in the interstitium of the lung parenchyme (A, H&E, x100) and two reactive lymphoid follicles with prominent germinal centers (B, arrows, H&E, x200) and areas of lymphocytic vasculitis (C, arrows, H&E, x200) are showed.
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There was dense lymphoplasmacytic infiltration in the interstitium of the lung parenchyme (Figure 5A) and the pleura forming reactive lymphoid follicles with germinal centers (Figure 5B). Multifocal areas of vasculitis (Figure 5C) and interstitial fibrosis were shown without any fibroblastic plug or honeycombing cystic change.