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Macroscopic inflammatory tracheal and endobronchial nodules in Sjögren's syndrome
  1. Hiromichi Hara,
  2. Kazuyoshi Kuwano,
  3. Shunsuke Minagawa,
  4. Takanori Numata,
  5. Jun Araya,
  6. Katsutoshi Nakayama
  1. Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Minatoku, Tokyo, Japan
  1. Correspondence to Dr Hiromichi Hara, Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, 3-19-18 Nishishimbashi, Minatoku, Tokyo 105-8471, Japan; hirohara{at}jikei.ac.jp

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A 38-year-old woman with primary Sjögren's syndrome (SS) presented with a 1 month history of cough and chest pain. She had been treated with prednisolone for organising pneumonia and had been on prednisolone (5 mg/day). Flexible bronchoscopy revealed macroscopic multiple nodules mainly in trachea and in both main bronchus (figure 1A). Three-dimensional CT (3D-CT) also demonstrated multiple nodules in the same place (figure 1B). Endobronchial biopsy showed polyclonal lymphocyte infiltration in the bronchial submucosa and epithelium in part (figure 1C, H & E: upper, CD3: middle, CD20: lower). There were few IgG4-positive plasma cells in the lesion. Amyloid …

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