title: [Reversed halo sign in organizing pneumonia secondary to Sjögren syndrome].
abstract: We report a case of a 41-year-old woman admitted to our hospital for dyspnea on exertion and nonproductive cough. High-resolution computed tomography (HRCT) revealed central ground-glass opacities surrounded by ring-shaped areas of consolidation (reversed halo sign), predominantly in the lower lobes. Bronchoalveolar lavage fluid revealed an increase of the total number of cells (35 x 10(4)/ml), including elevated lymphocyte level (69%) and decreased CD4/CD8 ratio (0.45). Histopathological examination by transbronchial lung biopsy showed polypoid masses of granulation tissue filling the lumens of a respiratory bronchiole and alveolar ducts, consistent with organizing pneumonia. After admission the patient complained of dry eyes and dry mouth. The serum anti-SS-A antibody level was also elevated (65.0 U/ml). Labial salivary gland biopsy specimens revealed focal lymphocytic infiltration of more than 50 per 4 mm(2). There were no findings of rheumatoid arthritis or other collagen diseases. We diagnosed primary Sjögren syndrome with secondary organizing pneumonia with a reversed halo sign. She was treated with prednisolone (0.5 mg/kg body weight, 35 mg/day). After treatment, the chest CT showed improvement through consolidation.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Anai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kumazoe
authors.forename: Kentarou
authors.initials: K
authors.lastname: Wakamatsu
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nagata
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Akira
authors.initials: A
authors.lastname: Kajiki
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000209:etiology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed