Asymptomatic lymphocytic interstitial pneumonia in primary Sjogren's syndrome

A woman in her 50s was referred by her general practitioner to the Emergency department for workup of mild hyponatraemia. Her background was significant for an established diagnosis of primary Sjogren's syndrome (pSS), and she was attending a rheumatologist regularly. Further investigations undertaken to establish the cause of her hyponatraemia included CT of the thorax, abdomen and pelvis, which revealed multiple ground glass opacities mostly in the lower lobes. CT-guided biopsy of the lesion in the left lower lobe revealed cores of lung parenchyma with chronic lymphoplasmacytic infiltration and fibrosis. Her case was discussed at the lung multidisciplinary meeting (MDM), and the consensus opinion was a diagnosis of Lymphocytic Interstitial Pneumonia (LIP) based on clinical, radiological and histological evidence. This case illustrates markedly abnormal radiological findings of LIP in a patient with pSS who has remained asymptomatic after a 2 year period of clinical, radiological and physiological monitoring.