0:00

So as you scroll through here,

0:02

you're gonna notice there aren't

0:03

that many cysts, but there are enough.

0:05

So probably there's like 30, 40 cysts here.

0:08

And if we scroll through, it looks like there is a bit

0:12

of basal predominance.

0:15

And so these are sort of non-specific cases

0:18

of diffuse cystic lung disease that can be harder

0:20

to make a differential diagnosis on.

0:23

So if I was reading this in isolation,

0:25

I would notice this patient was woman, a woman,

0:27

and then based on this profusion

0:30

of cyst within the lungs, I'd be stuck a little bit.

0:33

So I would probably put lymphangitis in my mitosis very high

0:36

on my differential diagnosis.

0:37

But this actually ends up being LIP lymphocytic,

0:40

interstitial pneumonitis in someone with Sjogren's syndrome.

0:44

And that's why as, and I've said this multiple times here,

0:47

uh, looking at the EMR

0:49

for these diffuse cystic lung disease is quite helpful.

0:51

So the patient's history

0:53

and their EMR, the promise, the first thing there was

0:55

history of Sjogren's syndrome.

0:57

So with diffuse cystic lung disease

0:59

and Sjogren's syndrome, this is just LIP, right?

1:01

Re regardless of the distribution, as long as it doesn't,

1:03

doesn't look like LCH.

1:04

This is just a little bit atypical pattern of lymphocytic,

1:08

interstitial pneumonitis.

1:09

But in isolation,

1:11

I wouldn't have been able to make the diagnosis.

1:12

And that's why, again, in diffuse lung disease, it helps

1:16

to combine the clinical history

1:19

and workup with our imaging findings.

1:21

And again, why MDD really is a gold standard in the setting

1:25

of interstitial lung disease.