Malignant Lymphoma Associated with Sjögren's Syndrome: A Case Report

Abstract

A case of malignant lymphoma associated with Sjögren's syndrome is reported. The patient was a 52-year-old woman, having photosensitivity in 1974, and foreign matter feeling and Raynaud's phenomenon in 1979.
In 1981 she had transient swelling of the left parotid gland. Reduced tear and saliva secretion and left parotid gland tumor were noted in June 1984.
On admission in October 1984 the left parotid gland tumor was 6×7 cm, and, in addition, general superficial lymphnode swelling was observed. Laboratory examinations revealed polyclonal hypergammaglobulinemia and autoimmune antibodies, such as anti-nuclear, anti-RNP, anti-Sm and anti-SS-A antibody. Concerning xerosis, bilateral keratoconjunctivitis sicca was seen, and an apple tree formation was demonstrated by sialogram. Biopsy of the lymphnodes showed diffuse proliferation of monoclonal cytoplasmic IgG, λ immunoblasts, leading to the diagnosis of malignant lymphoma (diffuse, large cell type based on L.S.G. classification).
The VEPA (vincristine, cyclophosphamide, prednisolone and adriamycin) therapy was given 5 cycles for the malignant lymphoma, and complete remission was attained.
No significant change in autoimmune antibodies was found during the period of observation.