Transformation of lymphoid interstitial pneumonia (LIP) into malignant lymphoma in patients with Sjogren's syndrome: a case report and literature review

Abstract

Background Lymphoid interstitial pneumonia (LIP) is a very rare disease and its malignant transformation is even more rare. LIP is easily misdiagnosed by clinicians and radiologists. Case presentation The medical record of a 64-year-old female with Sjogren's syndrome was reviewed. The clinical and pathological data along with chest CT images were obtained. The literature related to the transformation was reviewed. There were no specific clinical manifestations of LIP and its transformation into malignant lymphoma in the patient. The chest CT mainly displayed multiple cystic foci, with multiple nodules and ground-glass shadows in both lungs. Conclusions Malignant transformation to lymphoma is suspected with findings of large nodules (> 11 mm) or their sizes doubly increased, pleural effusion and alveolar consolidation.

Lymphocytic interstitial pneumonia presenting with a ground glass nodule: A case report and literature review

“…[ 2 , 3 ] In determining the diagnosis of LIP, the focus is on identifying the underlying disease (e.g., connective tissue disease, infection) and distinguishing LIP from malignant pulmonary lymphoproliferative disorders (e.g., lymphoma) as well as nonspecific interstitial pneumonia. [ 4 ]…”

“…Our patient had intermittent cough as the prominent clinical manifestation, and after admission to the hospital, relevant ancillary examinations were completed, and physical examination, pulmonary function, blood routine, and laboratory results were basically normal. Most patients had respiratory symptoms at the time of diagnosis, often presenting with cough, sputum and dyspnea, and progressive dyspnea and dry cough are now considered to be their main clinical characteristic manifestations, [ 4 , 5 ] while systemic symptoms such as fever, night sweats and weight loss are relatively uncommon. [ 6 ] Pulmonary function tests usually show restrictive ventilatory impairment.…”

“…[2,3] In determining the diagnosis of LIP, the focus is on identifying the underlying disease (e.g., connective tissue disease, infection) and distinguishing LIP from malignant pulmonary lymphoproliferative disorders (e.g., lymphoma) as well as nonspecific interstitial pneumonia. [4] LIP mostly has an insidious onset and lacks typical clinical manifestations. Our patient had intermittent cough as the prominent clinical manifestation, and after admission to the hospital, relevant ancillary examinations were completed, and physical examination, pulmonary function, blood routine, and laboratory results were basically normal.…”

Lymphocyte-Depleted Hodgkin’s Lymphoma in Coeliac Disease: A Diagnostic Challenge During the COVID-19 Pandemic

“…Primary LIP is rare, with most cases being secondary and usually associated with autoimmune diseases and viral infections. The mortality rate has been reported to be 33-50% within five years of diagnosis, and the transformation for malignant B-cell lymphoma is estimated to occur in 5% of the patients [ 5 ].…”

Lymphocytic interstitial non-HIV-related pneumonia in pediatrics: a case report

“…General management entails respiratory support measures through pulmonary rehabilitation, addressing secondary infections, and in severe cases of pulmonary involvement, lung transplantation may be warranted ( 1 , 11 , 12 , 16 ). The prognosis varies, mortality rates tend to be high when complications arise from the management, including pulmonary fibrosis, bronchiectasis, or lymphoma development ( 1 , 3 , 17 ).…”