A 50-year-old female patient, presenting with a past history of Reynaud's syndrome, xerostomia and xerophthalmia, was admitted to Fujian Provincial Hospital because of coughing for 10 days and left anterior chest pain for 1 day. Chest imaging showed multiple nodules and masses, and diffuse cystic lesions in both lungs. Based on the differential diagnosis of multiple pulmonary masses and diffuse cystic lesions respectively, autoantibodies, radionuclide dynamic imaging of the parotid, positron emission tomography-CT, CT-guided percutaneous transthoracic needle biopsy, and other examinations were performed. The diagnosis of diffuse large B-cell lymphoma stage ⅣA (lung, parotid gland) and Sjögren's syndrome was confirmed. By analyzing the imaging features and pathogenesis in detail, the diffuse cystic lesions of both lungs were considered to be related to lymphocytic interstitial pneumonia caused by Sjögren's syndrome. The pulmonary space-occupying lesions in the lungs were significantly absorbed after RCHOP regimen for lymphoma.
患者女，50岁，既往存在雷诺综合征、口干、眼干。此次因“咳嗽10 d，左前胸痛1 d”入院，胸部影像学提示双肺多发结节、团块，双肺弥漫性囊性病变。以“双肺多发占位、双肺弥漫性囊性病变”作为鉴别切入点，完善相关化验检查、经皮肺病灶穿刺活检，确诊弥漫大B细胞淋巴瘤ⅣA期（肺、腮腺）、干燥综合征。并通过详细分析影像特点及发病机制，考虑双肺弥漫性囊性病变与干燥综合征导致的肺部并发症，淋巴细胞间质性肺炎相关。而淋巴瘤经RCHOP方案治疗后肺部占位明显吸收。.