A 52-year-old woman with Sjogren syndrome presents with progressive bilateral parotid enlargement over 6 months, fatigue, and recent-onset peripheral neuropathy. Serum electrophoresis shows a polyclonal gammopathy. Complement C4 is low. What is the most likely underlying lymphoma associated with this presentation?
- A Diffuse large B-cell lymphoma
- B Marginal zone B-cell lymphoma (MALT lymphoma) ✓
- C Follicular lymphoma
- D Burkitt lymphoma
Correct answer: B. Marginal zone B-cell lymphoma (MALT lymphoma)
Explanation
Sjogren syndrome carries a 5 to 10 percent lifetime risk of lymphoma, predominantly marginal zone B-cell lymphoma (MALT type). Low complement C4, palpable purpica, and persistent parotid enlargement are risk factors. MALT lymphoma typically arises in salivary gland tissue and may be indolent initially.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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