A Case of Progressive Dyspnea: Lymphocytic Interstitial Pneumonia in Collagen Vascular Disease

Abstract

We describe an interesting rare case of a 61-year-old woman who was admitted to our hospital for exertional dyspnea, non-productive cough, and generalized weakness of six months duration. Her computed tomography was significant for ground-glass opacities combined with bibasilar consolidations and numerous pulmonary cysts. There can be a significant overlap in imaging findings of post-coronavirus disease 2019 (COVID-19) lung disease and interstitial lung disease from autoimmune diseases. We review in extensive detail the differential diagnosis for these imaging findings from a pulmonologist's perspective and discuss investigations required for further workup. Our patient underwent transbronchial biopsy and was eventually diagnosed with lymphocytic interstitial pneumonia with Sjogren predominant mixed connective tissue disease. We also review in detail the current literature and prognosis for this interesting disease.

Lymphocytic interstitial pneumonia presenting with a ground glass nodule: A case report and literature review

“…[ 7 ] As in other diffuse interstitial lung diseases, lung high-resolution CT is the radiological method of choice to determine the lung manifestations of LIP, with multiple bronchial cysts and diffuse interstitial infiltrates as its characteristic manifestations, [ 8 ] and studies have found ground-glass shadows lobular centers or small subpleural nodules, thickened bronchovascular bundles, thickened lobular septa and cysts as well. [ 3 , 9 , 10 ] The formation of a thin-walled cystic lumen may be associated with progressive obstruction and dilatation of the airway by lymphocytes infiltrating around the fine bronchi. [ 11 ] Misdiagnosis and missed diagnoses can easily occur with imaging alone, and the combined use of several diagnostic methods can improve its diagnostic accuracy.…”