CTICasesLymphoid Interstitial Pneumonia (LIP) in Sjogren Syndrome
Imaging findings
A middle-aged woman with Sjogren syndrome had CT showing multiple thin-walled, perivascular cysts along with somewhat blobby nodules associated with the cysts, findings first flagged after the nodules were noted to be hypermetabolic on PET, consistent with active lymphoid aggregates rather than simple protein deposition, typical of lymphoid interstitial pneumonia (LIP).
Key takeaways
Thin-walled perivascular cysts with associated nodules in a patient with Sjogren syndrome are characteristic of lymphoid interstitial pneumonia, and hypermetabolic activity on PET in these nodules reflects active lymphoid tissue rather than a false-positive for malignancy in most cases; nodules that grow beyond about two to three centimeters should raise concern for transformation to MALT lymphoma, a recognized complication of LIP.
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