A 51-year-old @entity1 was admitted to our hospital with exertional @entity1353 , swelling and @entity2693 in her fingers. @entity2407 and mammary and @entity3329 . She had received @entity1346 augmentation mammoplasty 30 years ago, and had since noticed bilateral mammary and @entity3329 that was stable in size. In the 2 years before admittance she had become aware of an exacerbation of the @entity3329 had begun to experience and exertional @entity1353 several months before admission suggesting a connective tissue disease. Physical examination revealed symmetrical weakness of the proximal limb muscles and fine crackles in the base of both lungs. Elevated myogenic enzymes, inflammatory reactions, and positive anti-SSA antibody were noted. Based upon these findings, muscle and lip biopsy results, myogenic EMG, and an apple tree appearance on sialography, a differential diagnosis of polymypositis or sj  gren's syndrome was made. Axillary lymph node biopsy findings were consistent with @entity1346 @entity3298 . In addition, chest roentgenogram and HRCT (which revealed decreased lung volumes and interstitial opacities with no honeycombing, present predominatly in the subpleural space), pulmonary function tests (decreased VC and DLco), bronchoalveolar lavage (elevated total cell count and neutrophil and eosinophil fractions), and transbronchial lung biopsy specimens (unevently distributed @entity3794 with @entity82 ) indicated concurrent @entity401 . The clinical correlation between exacerbation of @entity1346 @entity3329 and the development of connective tissue disease with accompanying @entity401 strongly suggested @entity1 @entity66 (HAD) as the pathogenesis. To our knowledge, @entity401 associated with HAD is rare.

[ @entity401 associated with XXXX @entity66 which developed 30 years after @entity1346 augmentation mammoplasty].

@entity1 :: ('9606', 'Species') :: ['woman', 'human'] @entity3329 :: ('MESH:D008206', 'Disease') :: ['lymphadenopathy', 'axillary lymphadenopathy'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity66 :: ('MESH:D004194', 'Disease') :: ['adjuvant disease'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['dyspnea'] @entity3794 :: ('MESH:D011658', 'Disease') :: ['alveolitis'] @entity2407 :: ('MESH:D011928', 'Disease') :: ["Raynaud's phenomenon"] @entity1346 :: ('MESH:D012828', 'Chemical') :: ['silicone'] @entity401 :: ('MESH:D017563', 'Disease') :: ['interstitial pneumonia'] @entity3298 :: ('MESH:D008199', 'Disease') :: ['lymphadenitis'] @entity2693 :: ('MESH:C566112', 'Disease') :: ['stiffness']
@entity1 :: (9606,Species) :: ['human']
