Rheumatoid arthritis with Sjogren's syndrome and MALT lymphoma of the parotid gland, associatedwith multiple myeloma: Description of a case and review of literature

Gorodetsky, V R; Пробатова, Н. А.; Логвиненко, О. А.; Васильев, В. И.; Ogorodnikova, M D; Седышев, С. Х.; Šimonová, Michaela; Safonova, T N; Varlamova, M Yu; Мехеда, Л В; Malakhova, N V; Насонов, Евгений Львович

doi:10.14412/1995-4484-2010-1423

Cited by 2 publications

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References 15 publications

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“…Los tumores de la glándula parotídea se relacionan principalmente con radiación [18], tabaco y ciertas infecciones virales (Epstein-Barr, HIV, VPH) [11]. Hasta en el 44% de los pacientes con linfoma MALT se asocian enfermedades autoinmunes, especialmente síndrome de Sjögren [19][20][21][22][23][24][25][26]. Este síndrome ataca a las glándulas exocrinas, especialmente a las glándulas salivales, y da lugar a una proliferación significativa de células B [27], la cual representa un importante factor de riesgo para el desarrollo de un linfoma de glándulas salivales.…”

Section: Materials Y Métodounclassified

Linfoma MALT de glándula parótida. Revisión sistemática

Fernández-García

Salom-Coveñas

2022

ORL

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Introducción y objetivo: Los linfomas de la glándula parótida son una entidad infrecuente. El objetivo de este estudio es realizar una revisión sistemática retrospectiva de la literatura sobre casos clínicos de linfomas MALT parotídeos. Se revisa su epidemiología y clínica más habitual, los métodos diagnósticos y tratamiento empleados y su pronóstico. Método: Revisión bibliográfica sistemática. Resultados: Se seleccionaron 28 estudios originales de casos o series, de los cuales 10 incluyeron más de 25 pacientes. Todos mostraron mayor incidencia en mujeres, en consonancia con su asociación con la presencia de enfermedades autoinmunes, específicamente con el síndrome de Sjögren. Los estudios evidenciaron la dificultad en el diagnóstico diferencial de otras patologías parotídeas. El tratamiento varió entre estudios, sin mostrar ninguno de ellos un claro beneficio respecto de los demás. Discusión: Se trata de un tipo de LNH relacionado principalmente con inflamación autoinmune crónica en el caso de aparición en glándulas salivales. Se presenta como una tumoración asintomática e inespecífica de crecimiento lento. Se diagnostica por su histología y se estudia su extensión mediante TC o RM en la mayoría de los casos. El tratamiento se realiza mediante parotidectomía asociada a quimioterapia y/o radioterapia. La tasa de supervivencia es >80% a los 5 años. Conclusiones: Los linfomas MALT de glándulas salivales son poco habituales y ocasionalmente se diagnostican de manera inadecuada debido a su comportamiento benigno, que mimetiza a tumores más familiares del área parotídea. Su sospecha y distinción son esenciales y no debe olvidarse en el diagnóstico diferencial de masas parotídeas.

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Section: Materials Y Métodounclassified

Linfoma MALT de glándula parótida. Revisión sistemática

Fernández-García

Salom-Coveñas

2022

ORL

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“…Учитывая, что отсутствие лечения или использование малоэффективных ГК, плавенила и метотрексата у пациентов с БШ и лимитированной формой ССД в конечном итоге приводило к высокой частоте развития лимфом в анализируемых исследованиях, следует тщательно относиться к терминологии изучаемых заболеваний. Мы ранее описывали возможность развития при сочетании БШ и РА одновременно двух типов НХЛ у одного пациента: MALT-лимфомы ОУСЖ при БШ и множественной миеломы при РА [42]. Определенные субтипы НХЛ развиваются при длительном течении РЗ, они четко классифицированы при БШ, СКВ, РА, но взаимосвязей их с ССД или субтипами этого заболевания не установлены [34].…”

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The relationship between Sjogren’s syndrome, systemic sclerosis and lymphoproliferative diseases

Васильев

Чальцев

Городецкий

et al. 2020

Terapevticheskii arkhiv

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Despite the large number of studies devoted to the study of systemic sclerosis (SSc), the high risk of developing lymphomas in this disease, the relationship of their development with certain subtypes of SSc and specific SSc-associated autoantibodies is still debated in the literature. Aim.To study demographic, clinical, laboratory and immunological characteristics of patients with a combination of primary Sjogrens syndrome (pSS) and SSc and diagnosed lymphoproliferative diseases (LPDs); to characterize morphological/immunomorphological variants and course of non-Hodgkins lymphomas (NHL), developing in patients with these rheumatic diseases (RDs). Materials and methods.In 19982018 at the Nasonova Research Institute of Rheumatology, 13 patients with clinical and laboratory manifestations of pSS (12) and SSc (13) were diagnosed with various lymphoproliferative diseases (LPDs). In 3 cases, an induced RD was observed: 1 case of a diffuse, rapidly progressive form of SSc, 2 cases of pSS in combination with a limited form of SSc after chemotherapy and radiation therapy of Hodgkins lymphoma (1), B-cell NHL (1) and CR of the breast (1) respectively. The first 2 cases were excluded from the analysis, since the development of lymphomas is not pathogenetically associated with RD. Results.Of 11 patients with LPDs, 10 after a long course of RDs were diagnosed with NHL [MALT lymphoma of the parotid salivary glands 7, disseminated MALT lymphoma 2, disseminated MALT lymphoma with transformation into diffuse large B-cell lymphoma (DLBCL) 1]. RDs debuted with Raynauds phenomenon (RP) in 64.5% and pSS manifestations in 45.5% of patients. Stomatological manifestations of pSS were characterized by recurrent parotitis in 36%, significant parotid gland enlargement with massive infiltration of labial salivary glands (focus score 4) in 100%, severe xerostomia in 70%, extraglandular manifestations and lymphadenopathy in 50% of patients. The course of the SSc was characterized by mild RP with various types of capillaroscopic changes and mild lung changes and non-significant progression during long-term follow-up (median 22 years). The entire spectrum of SSс specific antibodies (anticentromere antibodies 60%, antibodies to ribonucleoprotease III 30%, Pm/Scl 10%), excepting antibodies to topoisomerase I, as well as pSS specific autoantibodies (antiRo/La 70%, RF (rheumatoid factor) 90%), were detected in patients with a combination of these RDs. Conclusion.pSS is often combined with a limited form of SSc regardless of the type of autoantibodies detected. The presence of pSS, rather than SSc, is a high-risk factor for the development of NHL in this group of patients. The patients with pSS and SSc are characterized by a steady progression of pSS with a slow and mild course of SSc throughout the observation period. The development of severe stomatological manifestations and high immunological activity of pSS contribute to the development of localized MALT lymphomas (70%) and disseminated MALT lymphomas (30%) with primary lesions of the salivary glands and transformation into DLBCL in case of their late diagnosis. The optimal method for preventing the development of NHL in this group of patients is the early diagnosis of pSS, the appointment of alkylating cytotoxic agents and/or anti-B-cell therapy in the early stages of pSS. Given the possibility of transformation of localized NHL into DLBCL, for early diagnosis, minimally invasive surgical biopsies of significantly enlarged parotid salivary glands should be performed before glucocorticoids are prescribed. Detection of positive B-cell clonality and lymphoepithelial lesions in the parotid salivary gland is considered a predictor of MALT lymphoma development during follow-up. Localized and disseminated MALT lymphomas in patients with pSS and SSc respond well to therapy, in contrast to MALT lymphomas transformed into DLBCL.

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Rheumatoid arthritis with Sjogren's syndrome and MALT lymphoma of the parotid gland, associatedwith multiple myeloma: Description of a case and review of literature

Cited by 2 publications

References 15 publications

Linfoma MALT de glándula parótida. Revisión sistemática

Linfoma MALT de glándula parótida. Revisión sistemática

The relationship between Sjogren’s syndrome, systemic sclerosis and lymphoproliferative diseases

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