Voulgarelis et al evaluated patients with primary Sjogren's syndrome who developed malignant lymphoma. The authors are from multiple hospitals in Europe.
Patient selection: primary Sjogren's syndrome
Clinical findings that are seen more often in patients with malignant lymphoma:
(1) lymphadenopathy
(2) skin vasculitis
(3) peripheral neuropathy
(4) low-grade fever
Laboratory findings more often seen in patients with malignant lymphoma:
(1) anemia (hemoglobin < 11.5 g/dL)
(2) lymphopenia (absolute lymphocyte count < 1,500 per µL)
(3) cryoglobulinemia
(4) monoclonal protein
Prognostic factors associated with worse survival:
(1) intermediate or high grade malignant lymphoma
(2) B symptoms (fever, weight loss, night sweats)
(3) tumor diameter > 7 cm
