Oral malt-lymphoma in a patient with sjögren´s syndrome

A 61-year-old male patient presented a painless, soft, well-defined, expansive tumor in the soft palate, measuring 40 × 30mm, with superficial telangiectasia and five years of evolution. Extra oral examination revealed a fibrous nodular mass of 15mm in the left parotid gland. The patient reported dry mouth, gastritis, arthritis and arthrosis. Radiographs were uneventful. Blood tests were positive for rheumatoid factor, SS-A, SS-B, and antinuclear factor (HEP2) (nuclei). Sialometry was 0.09mL/minute. Incisional biopsy was performed in the soft palate tumor and in the lower lip. Neoplastic cells were immunopositive for CD20 and bcl2, CD3, CD138, and CD68 were positive in reactive cells. Cytokeratin evidenced lymphoepithelial lesions and Ki67 was around 30%. Absence of light chain monoclonality and negativity for bcl6, CD10, CD23, Cyclin-D1, and SOX11 were observed. The final diagnosis was oral MALT-lymphoma in a patient with Sjögren´s syndrome. The patient was referred to the onco-hematology center for treatment. Support: CAPES. A 61-year-old male patient presented a painless, soft, well-defined, expansive tumor in the soft palate, measuring 40 × 30mm, with superficial telangiectasia and five years of evolution. Extra oral examination revealed a fibrous nodular mass of 15mm in the left parotid gland. The patient reported dry mouth, gastritis, arthritis and arthrosis. Radiographs were uneventful. Blood tests were positive for rheumatoid factor, SS-A, SS-B, and antinuclear factor (HEP2) (nuclei). Sialometry was 0.09mL/minute. Incisional biopsy was performed in the soft palate tumor and in the lower lip. Neoplastic cells were immunopositive for CD20 and bcl2, CD3, CD138, and CD68 were positive in reactive cells. Cytokeratin evidenced lymphoepithelial lesions and Ki67 was around 30%. Absence of light chain monoclonality and negativity for bcl6, CD10, CD23, Cyclin-D1, and SOX11 were observed. The final diagnosis was oral MALT-lymphoma in a patient with Sjögren´s syndrome. The patient was referred to the onco-hematology center for treatment. Support: CAPES.