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[Gougerot-Sjögren syndrome and malignant lymphoproliferative syndromes]. 1998

B Grosbois, and P Jego, and R Leblay
Service de médecine interne G, Hôpital Sud, Rennes, France.

BACKGROUND This review is aimed at defining the frequency, anatomical and clinical presentation, pathogenesis, predictive factors and treatment of malignant lymphoproliferative diseases occurring in the course of Sjögren's syndrome. BACKGROUND The frequency of non-Hodgkin's lymphoma (NHL) is estimated to be about 7%. Other malignant lymphoproliferative diseases (Waldenstrom's macroglobulinemia, multiple myeloma, Hodgkin's disease) are rarely observed. NHL is most frequently extranodal (affecting the salivary glands, stomach, lung, etc) in low grade malignancy (MALT lymphoma [mucosa associated lymphoid tissue]). The pathogenesis of NHL in Sjögren's syndrome is a multi-step process, including B cell monoclonal proliferation, oncogenic and/or infectious agents, and/or cytokines. Various predictive factors such as persistent enlargment of parotid glands, adenopathy, splenomegaly, mixed cryoglobulinemia, monoclonal gammopathy, suggest potential lymphoma evolution. The treatment of Sjögren's syndrome-associated NHL depends on the type of lymphoma. Moreover, in patients with low-grade lymphoma therapeutical strategies varies according to the stage and evolution of the disease. CONCLUSIONS Future prospective longitudinal studies should permit to define the best criteria for malignant transformation and to improve therapeutical strategies.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008228 Lymphoma, Non-Hodgkin Any of a group of malignant tumors of lymphoid tissue that differ from HODGKIN DISEASE, being more heterogeneous with respect to malignant cell lineage, clinical course, prognosis, and therapy. The only common feature among these tumors is the absence of giant REED-STERNBERG CELLS, a characteristic of Hodgkin's disease. Non-Hodgkin Lymphoma,Diffuse Mixed Small and Large Cell Lymphoma,Diffuse Mixed-Cell Lymphoma,Diffuse Small Cleaved-Cell Lymphoma,Diffuse Undifferentiated Lymphoma,Lymphatic Sarcoma,Lymphoma, Atypical Diffuse Small Lymphoid,Lymphoma, Diffuse,Lymphoma, Diffuse, Mixed Lymphocytic-Histiocytic,Lymphoma, High-Grade,Lymphoma, Intermediate-Grade,Lymphoma, Low-Grade,Lymphoma, Mixed,Lymphoma, Mixed Cell, Diffuse,Lymphoma, Mixed Lymphocytic-Histiocytic,Lymphoma, Mixed Small and Large Cell, Diffuse,Lymphoma, Mixed-Cell,Lymphoma, Mixed-Cell, Diffuse,Lymphoma, Non-Hodgkin's,Lymphoma, Non-Hodgkin, Familial,Lymphoma, Non-Hodgkins,Lymphoma, Nonhodgkin's,Lymphoma, Nonhodgkins,Lymphoma, Pleomorphic,Lymphoma, Small Cleaved Cell, Diffuse,Lymphoma, Small Cleaved-Cell, Diffuse,Lymphoma, Small Non-Cleaved-Cell,Lymphoma, Small Noncleaved-Cell,Lymphoma, Small and Large Cleaved-Cell, Diffuse,Lymphoma, Undifferentiated,Lymphoma, Undifferentiated, Diffuse,Lymphosarcoma,Mixed Small and Large Cell Lymphoma, Diffuse,Mixed-Cell Lymphoma,Mixed-Cell Lymphoma, Diffuse,Non-Hodgkin's Lymphoma,Reticulosarcoma,Reticulum Cell Sarcoma,Reticulum-Cell Sarcoma,Sarcoma, Lymphatic,Sarcoma, Reticulum-Cell,Small Cleaved-Cell Lymphoma, Diffuse,Small Non-Cleaved-Cell Lymphoma,Small Noncleaved-Cell Lymphoma,Undifferentiated Lymphoma,Diffuse Lymphoma,Diffuse Lymphomas,Diffuse Mixed Cell Lymphoma,Diffuse Mixed-Cell Lymphomas,Diffuse Small Cleaved Cell Lymphoma,Diffuse Undifferentiated Lymphomas,High-Grade Lymphoma,High-Grade Lymphomas,Intermediate-Grade Lymphoma,Intermediate-Grade Lymphomas,Low-Grade Lymphoma,Low-Grade Lymphomas,Lymphatic Sarcomas,Lymphocytic-Histiocytic Lymphoma, Mixed,Lymphocytic-Histiocytic Lymphomas, Mixed,Lymphoma, Diffuse Mixed-Cell,Lymphoma, Diffuse Undifferentiated,Lymphoma, High Grade,Lymphoma, Intermediate Grade,Lymphoma, Low Grade,Lymphoma, Mixed Cell,Lymphoma, Mixed Lymphocytic Histiocytic,Lymphoma, Non Hodgkin,Lymphoma, Non Hodgkin's,Lymphoma, Non Hodgkins,Lymphoma, Nonhodgkin,Lymphoma, Small Non Cleaved Cell,Lymphoma, Small Noncleaved Cell,Lymphosarcomas,Mixed Cell Lymphoma,Mixed Cell Lymphoma, Diffuse,Mixed Lymphocytic-Histiocytic Lymphoma,Mixed Lymphocytic-Histiocytic Lymphomas,Mixed Lymphoma,Mixed Lymphomas,Mixed-Cell Lymphomas,Non Hodgkin Lymphoma,Non Hodgkin's Lymphoma,Non-Cleaved-Cell Lymphoma, Small,Non-Hodgkins Lymphoma,Noncleaved-Cell Lymphoma, Small,Nonhodgkin's Lymphoma,Nonhodgkins Lymphoma,Pleomorphic Lymphoma,Pleomorphic Lymphomas,Reticulosarcomas,Reticulum Cell Sarcomas,Reticulum-Cell Sarcomas,Sarcoma, Reticulum Cell,Small Cleaved Cell Lymphoma, Diffuse,Small Non Cleaved Cell Lymphoma,Small Non-Cleaved-Cell Lymphomas,Small Noncleaved Cell Lymphoma,Small Noncleaved-Cell Lymphomas,Undifferentiated Lymphoma, Diffuse,Undifferentiated Lymphomas
D008232 Lymphoproliferative Disorders Disorders characterized by proliferation of lymphoid tissue, general or unspecified. Duncan's Syndrome,X-Linked Lymphoproliferative Syndrome,Duncan Disease,Epstein-Barr Virus Infection, Familial Fatal,Epstein-Barr Virus-Induced Lymphoproliferative Disease In Males,Familial Fatal Epstein-Barr Infection,Immunodeficiency 5,Immunodeficiency, X-Linked Progressive Combined Variable,Lymphoproliferative Disease, X-Linked,Lymphoproliferative Syndrome, X-Linked, 1,Purtilo Syndrome,X-Linked Lymphoproliferative Disease,X-Linked Lymphoproliferative Disorder,Disease, Duncan,Disease, X-Linked Lymphoproliferative,Diseases, X-Linked Lymphoproliferative,Disorder, Lymphoproliferative,Disorder, X-Linked Lymphoproliferative,Disorders, Lymphoproliferative,Disorders, X-Linked Lymphoproliferative,Epstein Barr Virus Induced Lymphoproliferative Disease In Males,Epstein Barr Virus Infection, Familial Fatal,Familial Fatal Epstein Barr Infection,Immunodeficiency 5s,Immunodeficiency, X Linked Progressive Combined Variable,Lymphoproliferative Disease, X Linked,Lymphoproliferative Diseases, X-Linked,Lymphoproliferative Disorder,Lymphoproliferative Disorder, X-Linked,Lymphoproliferative Disorders, X-Linked,Lymphoproliferative Syndrome, X-Linked,Lymphoproliferative Syndromes, X-Linked,Purtilo Syndromes,Syndrome, Purtilo,Syndrome, X-Linked Lymphoproliferative,Syndromes, Purtilo,Syndromes, X-Linked Lymphoproliferative,X Linked Lymphoproliferative Disease,X Linked Lymphoproliferative Disorder,X Linked Lymphoproliferative Syndrome,X-Linked Lymphoproliferative Diseases,X-Linked Lymphoproliferative Disorders,X-Linked Lymphoproliferative Syndromes
D008258 Waldenstrom Macroglobulinemia A lymphoproliferative disorder characterized by pleomorphic B-LYMPHOCYTES including PLASMA CELLS, with increased levels of monoclonal serum IMMUNOGLOBULIN M. There is lymphoplasmacytic cells infiltration into bone marrow and often other tissues, also known as lymphoplasmacytic lymphoma. Clinical features include ANEMIA; HEMORRHAGES; and hyperviscosity. Lymphoma, Lymphoplasmacytoid,Macroglobulinemia,Familial Waldenstrom's Macroglobulinaemia,Lymphoma, Lymphocytic, Plasmacytoid,Primary Macroglobulinemia,Waldenstrom's Macroglobulinaemia,Waldenstrom's Macroglobulinemia,Familial Waldenstrom Macroglobulinaemia,Familial Waldenstroms Macroglobulinaemia,Lymphomas, Lymphoplasmacytoid,Lymphoplasmacytoid Lymphoma,Lymphoplasmacytoid Lymphomas,Macroglobulinaemia, Familial Waldenstrom's,Macroglobulinaemia, Waldenstrom's,Macroglobulinemia, Primary,Macroglobulinemia, Waldenstrom,Macroglobulinemia, Waldenstrom's,Waldenstrom Macroglobulinaemia,Waldenstrom's Macroglobulinaemia, Familial,Waldenstroms Macroglobulinaemia,Waldenstroms Macroglobulinemia
D009101 Multiple Myeloma A malignancy of mature PLASMA CELLS engaging in monoclonal immunoglobulin production. It is characterized by hyperglobulinemia, excess Bence-Jones proteins (free monoclonal IMMUNOGLOBULIN LIGHT CHAINS) in the urine, skeletal destruction, bone pain, and fractures. Other features include ANEMIA; HYPERCALCEMIA; and RENAL INSUFFICIENCY. Myeloma, Plasma-Cell,Kahler Disease,Myeloma, Multiple,Myeloma-Multiple,Myelomatosis,Plasma Cell Myeloma,Cell Myeloma, Plasma,Cell Myelomas, Plasma,Disease, Kahler,Multiple Myelomas,Myeloma Multiple,Myeloma, Plasma Cell,Myeloma-Multiples,Myelomas, Multiple,Myelomas, Plasma Cell,Myelomas, Plasma-Cell,Myelomatoses,Plasma Cell Myelomas,Plasma-Cell Myeloma,Plasma-Cell Myelomas
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D009857 Oncogenes Genes whose gain-of-function alterations lead to NEOPLASTIC CELL TRANSFORMATION. They include, for example, genes for activators or stimulators of CELL PROLIFERATION such as growth factors, growth factor receptors, protein kinases, signal transducers, nuclear phosphoproteins, and transcription factors. A prefix of "v-" before oncogene symbols indicates oncogenes captured and transmitted by RETROVIRUSES; the prefix "c-" before the gene symbol of an oncogene indicates it is the cellular homolog (PROTO-ONCOGENES) of a v-oncogene. Transforming Genes,Oncogene,Transforming Gene,Gene, Transforming,Genes, Transforming
D003449 Cryoglobulinemia A condition characterized by the presence of abnormal quantities of CRYOGLOBULINS in the blood. Upon cold exposure, these abnormal proteins precipitate into the microvasculature leading to restricted blood flow in the exposed areas. Cryoglobulinemias
D005544 Forecasting The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology. Futurology,Projections and Predictions,Future,Predictions and Projections
D006689 Hodgkin Disease A malignant disease characterized by progressive enlargement of the lymph nodes, spleen, and general lymphoid tissue. In the classical variant, giant usually multinucleate Hodgkin's and REED-STERNBERG CELLS are present; in the nodular lymphocyte predominant variant, lymphocytic and histiocytic cells are seen. Granuloma, Hodgkin,Granuloma, Malignant,Hodgkin Lymphoma,Lymphogranuloma, Malignant,Granuloma, Hodgkin's,Granuloma, Hodgkins,Hodgkin Lymphoma, Adult,Hodgkin's Disease,Hodgkin's Lymphoma,Hodgkins Disease,Lymphocyte Depletion Hodgkin's Lymphoma,Lymphocyte-Rich Classical Hodgkin's Lymphoma,Mixed Cellularity Hodgkin's Lymphoma,Nodular Lymphocyte-Predominant Hodgkin's Lymphoma,Nodular Sclerosing Hodgkin's Lymphoma,Adult Hodgkin Lymphoma,Disease, Hodgkin,Disease, Hodgkin's,Disease, Hodgkins,Hodgkin Granuloma,Hodgkin's Granuloma,Hodgkins Granuloma,Hodgkins Lymphoma,Lymphocyte Rich Classical Hodgkin's Lymphoma,Lymphogranulomas, Malignant,Lymphoma, Hodgkin,Lymphoma, Hodgkin's,Malignant Granuloma,Malignant Granulomas,Malignant Lymphogranuloma,Malignant Lymphogranulomas,Nodular Lymphocyte Predominant Hodgkin's Lymphoma

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