Clinical characteristics of primary Sjögren′s syndrome complicated with pulmonary nodules

doi:10.3877/cma.j.issn.1674-6902.2025.05.002

Abstract

Abstract:

Objective

To analyze the clinical characteristics of pulmonary nodules (PN) in patients with primary Sjögren′s syndrome (pSS).

Methods

A retrospective analysis was conducted on the clinical data, histopathological examination results, and chest CT imaging findings of 32 pSS patients with pulmonary nodules admitted to our hospital from May 2017 to December 2024.

Results

Among the 32 patients, 3 cases(9.38%) were male and 29 cases (90.62%) were female. Four patients (12.50%) had a history of smoking. Clinical manifestations included dry mouth 26 cases, dry eyes 12 cases, and arthralgia 7 cases. Respiratory symptoms (cough, chest tightness, chest pain, and hemoptysis) were present in 13 cases, while 17 cases had no respiratory symptoms and pulmonary nodules were discovered incidentally on physical examination CT. Immunoglobulin G (IgG) was elevated in 16 cases. Histopathological examination revealed benign lesions in 10 cases (31.25%), including pulmonary amyloidosis 2 cases, pulmonary granulomatous inflammation 2 cases, fibrocalcified nodules 1 case, and inflammatory cell infiltration 5 cases. Malignant tumors were found in 22 cases (68.88%), including lung cancer 17 cases, lymphoma 4 cases, and plasmacytoma 1 case. Respiratory symptoms (cough, chest tightness, chest pain, and hemoptysis) were significantly more common in patients with benign lesions compared to those with lung cancer or lymphoma (P<0.05). Patients with lymphoma had a significantly higher number of pulmonary nodules (P<0.05). Solitary pulmonary nodules and ground-glass opacity were associated with lung cancer. At the end of follow-up, 26 patients (81.25%) were alive, and 6 patients (18.75%) had died. Causes of death included lung cancer in 4 cases(12.50%), lymphoma in 1 case(3.12%), and benign lesions in 1 case(3.12%); one death was due to cerebral hemorrhage, and five were related to respiratory complications.

Conclusion

Malignant tumors are common findings in pSS patients with lung nodule biopsies. Solitary nodules and ground-glass opacity are frequently associated with lung cancer, while respiratory symptoms are more common in patients with benign lesions.

Key words: Pulmonary nodules, Sjogren′s syndrome, Lung tumor, Lymphoma

Bei Xu, Xiaomei Li, Li Wang, Yuwei Li, Xiaoling Xu, Zhuo Chen. Clinical characteristics of primary Sjögren′s syndrome complicated with pulmonary nodules[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 673-678.

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References 34

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临床资料	占比[n(%)]
呼吸道症状
咳嗽	11(34.38)
胸闷	6(18.75)
胸痛	2(6.25)
咯血	1(3.12)
ANA	24(75.00)
1︰100	1(3.12)
1︰320	7(21.88)
1︰1 000	9(28.12)
1︰3 200	7(21.88)
SSA(＋)	23(71.88)
SSB(＋)	9(28.12)
肺活检类型
气管镜	5(15.62)
经胸穿刺	11(34.38)
外科手术	16(50.00)

临床资料	占比[n(%)]
呼吸道症状
咳嗽	11(34.38)
胸闷	6(18.75)
胸痛	2(6.25)
咯血	1(3.12)
ANA	24(75.00)
1︰100	1(3.12)
1︰320	7(21.88)
1︰1 000	9(28.12)
1︰3 200	7(21.88)
SSA(＋)	23(71.88)
SSB(＋)	9(28.12)
肺活检类型
气管镜	5(15.62)
经胸穿刺	11(34.38)
外科手术	16(50.00)

组织病理学	构成[n(%)]
肺癌
肺腺癌	16(50.00)
肺鳞癌	1(3.12)
淋巴瘤
边缘区淋巴瘤	3(9.38)
弥漫性大B细胞淋巴瘤	1(3.12)
浆细胞瘤	1(3.12)
良性病变	10(31.25)
淀粉样变	2(6.25)
肉芽肿性炎	2(6.25)
纤维钙化	1(3.12)
炎性细胞浸润(淋巴细胞、浆细胞等)	5(15.62)

组织病理学	构成[n(%)]
肺癌
肺腺癌	16(50.00)
肺鳞癌	1(3.12)
淋巴瘤
边缘区淋巴瘤	3(9.38)
弥漫性大B细胞淋巴瘤	1(3.12)
浆细胞瘤	1(3.12)
良性病变	10(31.25)
淀粉样变	2(6.25)
肉芽肿性炎	2(6.25)
纤维钙化	1(3.12)
炎性细胞浸润(淋巴细胞、浆细胞等)	5(15.62)

临床特征	肺癌(n＝17)	淋巴瘤(n＝4)	良性病变(n＝10)	F值	P值
年龄[岁，(±s)]	57.58±11.16	60.25±6.95	52.00±12.55	1.082	0.353
性别[n(%)]					1.000
男	2(11.76)	0(0.00)	1(10.00)
女	15(88.24)	4(100.00)	9(90.00)
吸烟史[n(%)]	3(17.65)	0(0.00)	1(10.00)		1.000
呼吸道症状[n(%)]	2(11.76)	2(50.00)	9(90.00)		0.000
血常规[n(%)]
淋巴细胞数减少	7(41.18)	2(50.00)	5(50.00)		0.884
贫血	4(23.53)	1(25.00)	7(70.00)		0.060
血小板减少	3(17.65)	1(25.00)	1(10.00)		0.820
肺部CT影像
结节数[个，(±s)]	4.94±3.38	9.75±3.86	6.10±1.85	4.076	0.028
最大结节[mm，(±s)]	13.00±5.77	10.50±3.70	15.10±7.48	0.848	0.439
磨玻璃[n(%)]	14(82.35)	2(50.00)	1(10.00)		0.001
囊肿[n(%)]	1(5.88)	1(25.00)	3(30.00)		0.224
实变[n(%)]	2(11.76)	0(0.00)	3(30.00)		0.376
淋巴结增大[n(%)]	4(23.53)	1(25.00)	2(20.00)		1.000

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