We present a case of a 20-year-old woman reporting polyarthritis, muscle weakness, dyspnoea and multiple intensive care unit admissions due to respiratory failure, without haemoptysis, since 4 months of age. The mother had systemic erythematous lupus. On physical examination, digital clubbing and mild desaturation were found. Laboratory tests demonstrated 1:640 nuclear homogeneous pattern antinuclear antibodies (ANA) and erythrocyte sedimentation rate (ESR) of 61 mm. Spirometry exhibited forced vital capacity of 53%. High-resolution CT (HRCT) showed cysts and ground glass with reticular infiltrates (figure 1A-D). In 2006, she underwent a pulmonary biopsy, which revealed follicular bronchiolitis (figure 2A-D), without features of haemorrhage on biopsy such as haemosiderin laden macrophages. Figure 1 HRCT appearances. (A, B) Multiple well-circumscribed cysts in the parenchyma (arrows) and parenchymal reticulation with architectural distortion (arrowheads); (C, D) scattered ground glass opacities, more extensive in the lower lobes (circles). These findings correspond to an interstitial lung disease of unclassifiable pattern with parenchymal cysts. HRCT, high-resolution CT. Figure 2 Lung biopsy revealing. (A) Pulmonary parenchyma with lymphoid aggregates; (B) peribronchiolar (arrowhead) lymphoid aggregate with prominent germinative centre (arrow); (C) proliferation …

中文翻译：

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20岁自幼患有多关节炎的患者HRCT显示囊肿和毛玻璃衰减

我们介绍了一名 20 岁女性的病例，她自 4 个月大起患有多发性关节炎、肌肉无力、呼吸困难，并因呼吸衰竭多次入院重症监护室，但没有咯血。母亲患有系统性红斑狼疮。体检时发现杵状指和轻度饱和度下降。实验室检测显示1:640核同质型抗核抗体（ANA）和红细胞沉降率（ESR）为61毫米。肺活量测定显示用力肺活量为 53%。高分辨率 CT (HRCT) 显示囊肿和毛玻璃伴网状浸润（图 1A-D）。2006年，她接受了肺活检，结果显示滤泡性细支气管炎（图2A-D），活检没有出血特征，例如富含含铁血黄素的巨噬细胞。图1 HRCT表现。(A, B) 实质内多个边界清楚的囊肿（箭头）和伴有结构扭曲的实质网状结构（箭头）；(C、D) 散在毛玻璃样混浊，在下叶更广泛（圆圈）。这些发现对应于具有实质囊肿的无法分类模式的间质性肺病。HRCT，高分辨率CT。图2 肺活检显示。(A) 肺实质与淋巴聚集体；(B) 细支气管周围（箭头）淋巴聚集体，具有突出的萌发中心（箭头）；(C) 扩散……