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Sjögren-Associated Lymphoma — RACP Adult Medicine MCQ

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HardRheumatologySjögren-Associated LymphomaRACP Adult Medicine

A 65-year-old man with known Sjögren syndrome develops rapidly enlarging unilateral parotid mass over 2 months. He has B symptoms (fever, night sweats, weight loss). CT shows a solid parotid mass with cervical lymphadenopathy. LDH is elevated. What is the most likely diagnosis?

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Correct answer: A — Lymphoma

Rapidly enlarging unilateral parotid mass with B symptoms and cervical lymphadenopathy in Sjögren syndrome is lymphoma until proven otherwise. MALT (marginal zone) lymphoma and DLBCL are the most common subtypes. Risk of lymphoma in Sjögren is 5–10% lifetime. Urgent biopsy and haematology referral are required.

Reference: eTG Rheumatology – 2024 – Sjögren Complications; ESMO 2024