Primary Sjögren's syndrome and associated lung disease: CT findings in 50 patients.

Franquet, Tomás; Giménez, A.; Monill, J M; Díaz, César; Geli, C.

doi:10.2214/ajr.169.3.9275871

Cited by 158 publications

(100 citation statements)

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“…interstitial pneumonitis) and bronchiolocentric lymphocyte infiltration but, unlike rheumatoid arthritis, constrictive bronchiolitis is rarely the dominant presenting feature [59,60].…”

Section: Constrictive (Obliterative) Bronchiolitismentioning

confidence: 99%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

146

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Diseases affecting the small airways are difficult to detect by traditional diagnostic tests. Widespread involvement is needed before symptoms and abnormalities on pulmonary function testing or chest radiography become apparent. Obstruction of the bronchioles may be detected indirectly by computed tomography (CT) because regional under-ventilation results in reduced perfusion which in turn is shown as a mosaic attenuation pattern of the lung parenchyma. When there is inflammation of the bronchioles with accompanying exudate, the airways may become directly visible on CT, for example in cases of diffuse panbronchiolitis.Quantification of the various morphological features of small airways disease is possible from CT images and this increased precision has aided investigations of structure/function relationships.An understanding of the pathology and microscopic distribution of disease in relation to the airways allows some prediction of the likely computed tomography appearances in this wide spectrum of conditions, and thus helps to refine the differential diagnosis.

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“…interstitial pneumonitis) and bronchiolocentric lymphocyte infiltration but, unlike rheumatoid arthritis, constrictive bronchiolitis is rarely the dominant presenting feature [59,60].…”

Section: Constrictive (Obliterative) Bronchiolitismentioning

confidence: 99%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

146

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“…A variety of pulmonary abnormalities, including ILD, airways disease, and vascular disease, are associated with SS [7][8][9][10][11][12][13][14][15][16][17][18][19] (see the comprehensive review by Quismorio 19 ). The frequency of specific pulmonary abnormalities associated with pSS in published studies [7][8][9][10][11][12][13][14][15][16][17][18][19] is variable.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of specific pulmonary abnormalities associated with pSS in published studies [7][8][9][10][11][12][13][14][15][16][17][18][19] is variable. This variability is due to several factors, including the lack of uniform diagnostic criteria for SS, differing modalities to define pulmonary abnormalities, the variability in the number of current or former smokers and the possible presence of smoking-related lung disease, and the inclusion of patients with pSS or secondary SS.…”

Section: Discussionmentioning

confidence: 99%

Minor Salivary Gland Biopsy To Detect Primary Sjögren Syndrome in Patients With Interstitial Lung Disease

Fischer

Swigris

Bois

et al. 2009

Chest

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Purpose: To describe a cohort of patients who presented with interstitial lung disease (ILD) of unknown cause, features of primary Sjö gren syndrome (pSS), and a positive minor salivary gland biopsy (MSGB). Methods: Thirty-eight patients with ILD evaluated at our center underwent an MSGB to confirm a diagnosis of pSS. All of the samples were reviewed by pathologists experienced in the evaluation of salivary gland histology. We defined a positive MSGB finding as a lymphocyte focus score of >1. Results: At presentation, all patients had ILD, and symptoms of cough and dyspnea. None had a definable connective tissue disease (CTD) or known cause for their ILD. Thirteen patients (34%) had positive MSGB findings. Of these, the median age was 61 years (age range, 33 to 75 years); 7 patients (54%) were women; 8 patients (62%) had a smoking history; and 10 patients (77%) had sicca symptoms. In all patients, a thoracic high-resolution CT scan evaluation demonstrated bibasilar, peripheral-predominant, ground-glass, and reticular opacities. Four patients (31%) were negative for both antinuclear autoantibody (ANA) and rheumatoid factor (RF) autoantibody, and three patients (23%) were negative for ANA, RF, Sjö gren syndrome (SS)-A, and SS-B autoantibodies. No patients experienced any complications from the MSGB. The identification of underlying pSS did not affect the management of ILD in these patients. Conclusions: Confirming a diagnosis of pSS-related ILD by performing MSGB allows for a more precise CTD classification. This study provides evidence that CTD may exist subclinically, and longitudinal studies are needed to determine whether identifying occult CTD impacts on management, longitudinal changes in lung function, or survival.

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“…The findings are often associated with a fine reticulation (Figure 15). [95][96][97][98] Among 60 patients with primary SS, Koyama et al 97 found ground-glass opacities in 92%, centrilobular nodules in 78%, nonseptal linear opacities in 75%, interlobular septal thickening in 55%, bronchiectasis in 38%, and cysts in 30% of patients. Honeycombing is infrequent in primary SS (7%) but is more common in secondary SS (29%).…”

Section: Radiologic Findingsmentioning

confidence: 99%

Pleuropulmonary Pathology in Patients With Rheumatic Disease

Schneider

Gruden

Tazelaar

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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Thoracic manifestations of rheumatic disease (RD) are increasingly recognized as a significant cause of morbidity and mortality worldwide. Rheumatologic underpinnings have been identified in a significant proportion of patients with interstitial lung disease. The 5 RDs most frequently associated with pleuropulmonary disease are (1) rheumatoid arthritis, (2) systemic lupus erythematosus, (3) progressive systemic sclerosis, (4) polymyositis/dermatomyositis, and (5) Sjögren syndrome. The onset of thoracic involvement in these diseases is variable. In some patients, it precedes the systemic disease or is its only manifestation. Moreover, there is a wide spectrum of clinical presentation ranging from subclinical abnormalities to acute respiratory failure. Histopathologically, the hallmark features of thoracic involvement by RD are inflammatory, targeting one or more lung compartments. The reactions range from acute to chronic, with remodeling by fibrosis being a common result. Although the inflammatory findings are often nonspecific, certain reactions or anatomic distributions may favor one RD over another, and occasionally, a distinctive histopathology may be present (eg, rheumatoid nodules). Three diagnostic dilemmas are encountered in patients with RD who develop diffuse lung disease: 1) opportunistic infection in the immunocompromised host, 2) drug toxicity related to the medications used to treat the systemic disease, and 3) manifestations of the patient's known systemic disease in lung and pleura. To confidently address the latter, the 5 major RDs are presented here, with their most common pleuropulmonary pathologic manifestations, accompanied by brief clinical and radiologic correlations.

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Primary Sjögren's syndrome and associated lung disease: CT findings in 50 patients.

Cited by 158 publications

References 0 publications

Small airways diseases: detection and insights with computed tomography

Small airways diseases: detection and insights with computed tomography

Minor Salivary Gland Biopsy To Detect Primary Sjögren Syndrome in Patients With Interstitial Lung Disease

Pleuropulmonary Pathology in Patients With Rheumatic Disease

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