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Published in: BMC Pulmonary Medicine 1/2020

Open Access 01-12-2020 | Idiopathic Pulmonary Fibrosis | Research article

Evaluation of lymphocytic infiltration in the bronchial glands of Sjögren’s syndrome in transbronchial lung cryobiopsy

Authors: Hiroko Okabayashi, Tomohisa Baba, Ryota Ootoshi, Ryota Shintani, Erina Tabata, Satoshi Ikeda, Takashi Niwa, Tsuneyuki Oda, Ryo Okuda, Akimasa Sekine, Hideya Kitamura, Shigeru Komatsu, Eri Hagiwara, Tamiko Takemura, Takuro Sakagami, Takashi Ogura

Published in: BMC Pulmonary Medicine | Issue 1/2020

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Abstract

Background

Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by deteriorated exocrine gland function with associated lymphocytic infiltration. However, there are few pathological studies on bronchial glands in SS. In this study, we aimed to clarify pathological features of bronchial glands in SS.

Methods

We retrospectively evaluated infiltration of lymphocytes in the bronchial glands incidentally collected by transbronchial lung cryobiopsy (TBLC), which were performed for the diagnosis of diffuse lung diseases. The degrees of lymphocyte infiltration in the bronchial glands were classified into four grades (grade 0–3). We compared the degrees of infiltration of SS with those of other diffuse lung diseases.

Results

TBLC for diagnosis of diffuse lung diseases were performed on 432 cases during the study period. The samples of 50 cases included bronchial glands. Of those, 20 cases were excluded due to insufficient size or influence of therapy. The remaining 30 cases included 17 of idiopathic interstitial pneumonias, 5 of chronic hypersensitivity pneumonia, 6 of connective tissue disease (SS; n = 4, systemic sclerosis; n = 1, dermatomyositis; n = 1) and 2 of other diseases. In SS, infiltration of lymphocytes was observed in all cases; grade 1 in one, grade 2 in one, and grade 3 in two cases. In contrast, 11 of 26 in other diseases showed no lymphocytes infiltration, with the remaining 15 of grade 1 infiltration. Grade 2 or more infiltration were found only in SS but not in other diseases.

Conclusion

Our results suggested that high-grade lymphocytic infiltration of bronchial glands is a distinct characteristics in SS.
Literature
1.
go back to reference Chisholm DM, Mason DK. Labial salivary gland biopsy in Sjögren's syndrome. J Clin Pathol. 1968;21:656–60.CrossRef Chisholm DM, Mason DK. Labial salivary gland biopsy in Sjögren's syndrome. J Clin Pathol. 1968;21:656–60.CrossRef
2.
go back to reference Vitali C, Bombardieri S, Moutsopoulos HM, et al. Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993;36:340–7.CrossRef Vitali C, Bombardieri S, Moutsopoulos HM, et al. Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993;36:340–7.CrossRef
3.
go back to reference Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the Amrican-European consensus group. Ann Rheum Dis. 2002;61:554–8.CrossRef Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the Amrican-European consensus group. Ann Rheum Dis. 2002;61:554–8.CrossRef
4.
go back to reference Lentz RJ, Argento AC, Colby TV, Rickman OB, Maldonado F. Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art review of procedural techniques, current evidence, and future challenges. J Thorac Dis. 2017;9:2186–203.CrossRef Lentz RJ, Argento AC, Colby TV, Rickman OB, Maldonado F. Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art review of procedural techniques, current evidence, and future challenges. J Thorac Dis. 2017;9:2186–203.CrossRef
5.
go back to reference Casoni GL, Tomassetti S, Cavazza A, et al. Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases. PLoS One. 9:e86716. Casoni GL, Tomassetti S, Cavazza A, et al. Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases. PLoS One. 9:e86716.
6.
go back to reference Hetzel J, Maldonado F, Ravaglia C, et al. Transbronchial cryobiopsies for the diagnosis of diffuse parenchymal lung diseases: expert statement from the cryobiopsy working group on safety and utility and a call for standardization of the procedure. Respiration. 2018;95:188–200.CrossRef Hetzel J, Maldonado F, Ravaglia C, et al. Transbronchial cryobiopsies for the diagnosis of diffuse parenchymal lung diseases: expert statement from the cryobiopsy working group on safety and utility and a call for standardization of the procedure. Respiration. 2018;95:188–200.CrossRef
7.
go back to reference Iftikhar IH, Alghothani L, Sardi A, Berkowitz D, Musani AI. Transbronchial lung cryobiopsy and video-assisted thoracoscopic lung biopsy in the diagnosis of diffuse parenchymal lung disease. A meta-analysis of diagnostic test accuracy. Ann Am Thorac Soc. 2017;14:1197–211.PubMed Iftikhar IH, Alghothani L, Sardi A, Berkowitz D, Musani AI. Transbronchial lung cryobiopsy and video-assisted thoracoscopic lung biopsy in the diagnosis of diffuse parenchymal lung disease. A meta-analysis of diagnostic test accuracy. Ann Am Thorac Soc. 2017;14:1197–211.PubMed
8.
go back to reference Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidiscipilinary classification of the idhiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188:733–48.CrossRef Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidiscipilinary classification of the idhiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188:733–48.CrossRef
9.
go back to reference Vasakova M, Morell F, Walsh S, Lesile K, Raghu G. Hypersensitivity pneumonitis: perspectives in diagnosis and management. Am J Respir Crit Care Med. 2017;196:680–9.CrossRef Vasakova M, Morell F, Walsh S, Lesile K, Raghu G. Hypersensitivity pneumonitis: perspectives in diagnosis and management. Am J Respir Crit Care Med. 2017;196:680–9.CrossRef
10.
go back to reference American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002;165:277–304. American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002;165:277–304.
11.
go back to reference van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum. 2013;65:2737–47.CrossRef van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum. 2013;65:2737–47.CrossRef
12.
go back to reference Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344–8.CrossRef Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344–8.CrossRef
13.
go back to reference Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975;292:403–7.CrossRef Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975;292:403–7.CrossRef
14.
go back to reference Sontheimer RD. Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis sine myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness? J Am Acad Dermatol. 2002;46:626–36.CrossRef Sontheimer RD. Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis sine myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness? J Am Acad Dermatol. 2002;46:626–36.CrossRef
15.
go back to reference Sontheimer RD. Dermatomyositis: an overview of recent progress with emphasis on dermatologic aspects. Dermatol Clin. 2002;20:387–408.CrossRef Sontheimer RD. Dermatomyositis: an overview of recent progress with emphasis on dermatologic aspects. Dermatol Clin. 2002;20:387–408.CrossRef
16.
go back to reference Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum. 2013;65:1–11.CrossRef Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum. 2013;65:1–11.CrossRef
17.
go back to reference The 2016 revision of the World Health Organization classification of lymphoid neoplasms. published 2017. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. published 2017.
18.
go back to reference Kampolis CF, Fragkioudaki S, Mavragani CP, Zormpala A, Samakovil A, Moutsopoulos HM. Prevalence and spectrum of symptomatic pulmonary involvement in primary Sjögren's syndrome. Clin Exp Rheumatol. 2018;112:94–101. Kampolis CF, Fragkioudaki S, Mavragani CP, Zormpala A, Samakovil A, Moutsopoulos HM. Prevalence and spectrum of symptomatic pulmonary involvement in primary Sjögren's syndrome. Clin Exp Rheumatol. 2018;112:94–101.
19.
go back to reference Ito I, Nagai S, Kitaichi M, et al. Pulmonary manifestations of primary Sjögren's syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med. 2005;171:632–8.CrossRef Ito I, Nagai S, Kitaichi M, et al. Pulmonary manifestations of primary Sjögren's syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med. 2005;171:632–8.CrossRef
20.
go back to reference Stojan G, Baer AN, Danoff SK. Pulmonary manifestations of Sjögren's syndrome. Curr Allergy Asthma Rep. 2013;13:354–60.CrossRef Stojan G, Baer AN, Danoff SK. Pulmonary manifestations of Sjögren's syndrome. Curr Allergy Asthma Rep. 2013;13:354–60.CrossRef
21.
go back to reference Flament T, Bigot A, Chaigne B, Henique H, Diot E, Marchand-Adam S. Pulmonary manifestations of Sjögren's syndrome. Eur Respir Rev. 2016;25:110–23.CrossRef Flament T, Bigot A, Chaigne B, Henique H, Diot E, Marchand-Adam S. Pulmonary manifestations of Sjögren's syndrome. Eur Respir Rev. 2016;25:110–23.CrossRef
22.
go back to reference Enomoto Y, Takemura T, Hagiwara E, et al. Prognostic factors in interstitial lung disease associated with primary Sjogren’s syndrome: a retrospective analysis of 33 pathologically-proven cases. PLoS One. 2013;8(9):e 73774 Doi 10.CrossRef Enomoto Y, Takemura T, Hagiwara E, et al. Prognostic factors in interstitial lung disease associated with primary Sjogren’s syndrome: a retrospective analysis of 33 pathologically-proven cases. PLoS One. 2013;8(9):e 73774 Doi 10.CrossRef
23.
go back to reference Enomoto Y, Takemura T, Hagiwara E, et al. Features of usual interstitial pneumonia in patients with primary Sjogern’s synsdrome compared with idiopathic pulmonary fibrosis. Respir Investig. 2014;52:227–35.CrossRef Enomoto Y, Takemura T, Hagiwara E, et al. Features of usual interstitial pneumonia in patients with primary Sjogern’s synsdrome compared with idiopathic pulmonary fibrosis. Respir Investig. 2014;52:227–35.CrossRef
24.
go back to reference Butnor KJ, Khoor A. Collagen Vascular Disease and Disorders of Connective Tissue. In: Tomashefski Jr JF, editor. Dail Hammar’s Pilm.Pathol. [Internet]. New York: Springer; 2008. p. 722–59. [cited 2013 Apr 4] A variable from: http://link.springer.com/chapter/10.1007/978-0-387-68792-6_20.CrossRef Butnor KJ, Khoor A. Collagen Vascular Disease and Disorders of Connective Tissue. In: Tomashefski Jr JF, editor. Dail Hammar’s Pilm.Pathol. [Internet]. New York: Springer; 2008. p. 722–59. [cited 2013 Apr 4] A variable from: http://​link.​springer.​com/​chapter/​10.​1007/​978-0-387-68792-6_​20.​CrossRef
25.
go back to reference Inase N, Usui Y, Tachi H, et al. Sjögren's syndrome with bronchial gland involvement and multiple bullae. Respiration. 1990;57:286–8.CrossRef Inase N, Usui Y, Tachi H, et al. Sjögren's syndrome with bronchial gland involvement and multiple bullae. Respiration. 1990;57:286–8.CrossRef
26.
go back to reference Andoh Y, Shimura S, Sawai T, Sasaki H, Takashima T, Shirato K. Morphometric analysis of airways in Sjögren's syndrome. Am Rev Respir Dis. 1993;148:1358–62.CrossRef Andoh Y, Shimura S, Sawai T, Sasaki H, Takashima T, Shirato K. Morphometric analysis of airways in Sjögren's syndrome. Am Rev Respir Dis. 1993;148:1358–62.CrossRef
27.
go back to reference Hayashi Y, Ishimaru N, Omotehara F. Autoimmunity lesion of the salivary gland. Pathol Clin Med. 2005;23:116–21 [Japanese]. Hayashi Y, Ishimaru N, Omotehara F. Autoimmunity lesion of the salivary gland. Pathol Clin Med. 2005;23:116–21 [Japanese].
28.
go back to reference Saetta M, Turato G, Facchini FM, et al. Inflammatory cells in the bronchial glands of smokers with chronic bronchitis. Am J Respir Crit Care Med. 1997;156:1633–9.CrossRef Saetta M, Turato G, Facchini FM, et al. Inflammatory cells in the bronchial glands of smokers with chronic bronchitis. Am J Respir Crit Care Med. 1997;156:1633–9.CrossRef
Metadata
Title
Evaluation of lymphocytic infiltration in the bronchial glands of Sjögren’s syndrome in transbronchial lung cryobiopsy
Authors
Hiroko Okabayashi
Tomohisa Baba
Ryota Ootoshi
Ryota Shintani
Erina Tabata
Satoshi Ikeda
Takashi Niwa
Tsuneyuki Oda
Ryo Okuda
Akimasa Sekine
Hideya Kitamura
Shigeru Komatsu
Eri Hagiwara
Tamiko Takemura
Takuro Sakagami
Takashi Ogura
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2020
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-020-01318-0

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