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 …