Longitudinal lung involvement of systemic lupus erythematosus‐related vasculitis and alveolar proteinosis‐like reaction

A 44‐year‐old woman with no symptoms was referred to our hospital for thorough examination of consolidation opacity on her left lung, which was growing for four years. She was diagnosed with systemic lupus erythematosus (SLE) at the age of 35 years and had been treated with prednisolone 10 mg/day. Physical examination and bronchoscopy revealed no abnormality including microbiological tests. She underwent surgical resection of the lung lesion. Lung biopsy specimens showed aggregation of lymphocytes with germinal centres and collagen deposition. Vasculitis and pulmonary alveolar proteinosis (PAP)‐like reaction were also found. We diagnosed this lung opacity as an SLE‐related lung lesion with vasculitis and PAP‐like reaction. Lung involvement of SLE is scarce and long‐term lung vasculitis and PAP‐like reaction are extremely rare in patients with SLE. Clinicians should be aware of such SLE‐related lung consolidation opacity that comprises lung vasculitis and PAP‐like reaction.