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Summary

This case study highlights a rare presentation of diffuse large B-cell lymphoma and Sjögren's syndrome in a 50-year-old female. Treatment with the RCHOP regimen led to significant absorption of pulmonary lesions.

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Area of Science:

  • Pulmonology
  • Oncology
  • Rheumatology

Background:

  • Sjögren's syndrome is a chronic autoimmune disease primarily affecting exocrine glands.
  • Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
  • Co-occurrence of autoimmune diseases and lymphoma presents diagnostic challenges.

Observation:

  • A 50-year-old female with a history of Reynaud's syndrome, xerostomia, and xerophthalmia presented with cough and chest pain.
  • Chest imaging revealed multiple pulmonary nodules, masses, and diffuse cystic lesions.
  • Diagnostic workup included autoantibody testing, imaging, and biopsy.

Findings:

  • The patient was diagnosed with stage ⅣA diffuse large B-cell lymphoma involving the lungs and parotid gland, concurrently with Sjögren's syndrome.
  • Diffuse cystic lung lesions were attributed to Sjögren's syndrome-associated lymphocytic interstitial pneumonia.
  • Pulmonary lesions showed significant improvement following the RCHOP chemotherapy regimen for lymphoma.

Implications:

  • This case underscores the importance of considering lymphoma in patients with Sjögren's syndrome presenting with pulmonary abnormalities.
  • Early diagnosis and combined treatment strategies are crucial for managing co-existing conditions.
  • Understanding the interplay between autoimmune disorders and lymphoproliferative diseases can improve patient outcomes.