B-Cell Lymphoma Associated with Sjogren's Syndrome among Japanese Patients : A Clinicopathologic and Immunohistochemical Study of 15 Cases

To clarify the clinicopathological findings of B-cell lymphoma associated with Sjgren's syndrome (SJS) among Japanese Patients, 15 individuals with this disease were studied. The patients, 14 females and one male, ranged in age from 41 to 73 years with a median age of 56 years. These lymphomas arose not only in the salivary gland (n=4) but also in other mucosal extranodal sites (n=5). Histologically, six cases were marginal zone B-cell lymphoma (MZBL) of the mucosa-associated lymphoid tissue (MALT) type, three cases were diffuse large B-cell lymphoma (DLBCL) + MALT type lymphoma, two cases were nodal MZBL and one case each was small lymphocytic lymphoma, Burkitt's lymphoma, CD10+ DLBCL and DLBCL + nodal MZBL. Using in situ hybridization, numerous Epstein-Barr virus+ tumor cells were detected only in the case of Burkitt lymphoma. There were no human-herpes type 8+ tumor cells in any of the 15 cases. There was no API2-MALT1 fusion transcript in any of the eight cases examined. B-cell lymphoma associated with SJS also frequently affected extranodal organs in patients from Japan as well as from patients in Western countries. The majority of B-cell lymphomas in patients with SJS also appear to be low-grade MZBLs or high-grade lymphomas probably derived from MZBL both in Western countries and in Japan.