Pulmonary Lymphoma in Sjögren's Syndrome
Section snippets
MATERIAL AND METHODS
We reviewed the records of all Mayo Clinic patients with the diagnosis of SS and lymphoma. Only the records of patients with an unequivocal diagnosis of SS (sicca complex only, without evidence of other causes of “sicca-like” symptoms, or sicca complex associated with rheumatoid arthritis or other collagen disease and a clinical course suggestive of SS) and associated lymphoma were selected for study. The diagnosis of SS was based primarily on clinical findings and occasionally on laboratory
RESULTS
Both SS and lymphoma were diagnosed in 50 patients, and pulmonary lymphoma developed in 10 of these patients. Three patients had been included in an earlier Mayo Clinic report on the pulmonary manifestations in SS.13 The clinical features of the 10 patients, 8 of whom were women, are outlined in Table 1. The mean age of these patients was 59.7 years (range, 42 to 74 years). Seven patients had primary SS, and three had secondary SS in association with rheumatoid arthritis. The duration of SS
DISCUSSION
Among the autoimmune collagen disorders, SS is the second most commonly encountered (rheumatoid arthritis is the most frequent).7 The prevalence of SS is estimated to be between 0.5 and 2.0% of the general population; most patients are in the age group of 43 to 54 years at the time of diagnosis, and the female-to-male ratio is 9 to 1.9, 28, 29 Although various clinical features and laboratory tests have been recommended for the diagnosis of SS, no established criteria have been uniformly
CONCLUSION
This study demonstrates that patients with SS may have pulmonary lymphoma. The presence of pulmonary infiltrates in patients with SS should prompt the consideration of involvement of the lungs by lymphoma.
ACKNOWLEDGMENT
We thank Peter M. Banks, M.D., formerly of the Division of Pathology, for the review of pathologic specimens for this study.
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Current address: Yankton Medical Clinic, Yankton, South Dakota.