Metachronous development of Hodgkin’s lymphoma and nodal marginal zone lymphoma in a patient with Sjögren’s syndrome: a case report
- Authors: Diakonova M.N.1, Pavlyuchenko E.S.1, Mirsaitov A.A.1, Byrsan R.Y.1, Leenman E.E.1, Bekhtereva I.A.1, Liz E.A.1, Mazurov V.I.1
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Affiliations:
- North-West State Medical University named after I.I. Mechnikov
- Issue: Vol 17, No 2 (2025)
- Pages: 114-121
- Section: Case report
- Submitted: 04.10.2024
- Accepted: 23.05.2025
- Published: 30.07.2025
- URL: https://journals.eco-vector.com/vszgmu/article/view/636448
- DOI: https://doi.org/10.17816/mechnikov636448
- EDN: https://elibrary.ru/RHPTDE
- ID: 636448
Cite item
Abstract
According to various population-based studies, lymphoproliferative disorders develop 2–10 times more frequently in individuals with autoimmune pathology compared to the general population. Patients with Sjögren's disease/syndrome exhibit 10–44 times increased risk of lymphoma development compared to the general population. This predisposition is primarily driven by chronic B-cell stimulation from autoantigens produced by exocrine glands and other organs. However, no clear therapeutic guidelines for the management of these patients have been published.
This report presents a unique case of metachronous development of Hodgkin's lymphoma and nodal marginal zone lymphoma in a patient with Sjögren’s syndrome. The diagnostic workup is described in detail, including histopathological and immunohistochemical findings as well as imaging studies, along with the therapeutic approaches employed. The main difficulty in treatment was the alternation of recurrent course of lymphomas amid immunological dysregulation and autoaggression aggravated by checkpoint inhibitors, especially immune damage to the liver. The issue of the formation of an optimal therapeutic approach in this category of patients is raised in this article. The article examines the relationship between autoimmune pathology and lymphoproliferative disorders, addressing fundamental questions about the primacy of pathological processes and the development of optimal diagnostic and therapeutic approaches for this patient category.
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About the authors
Mariia N. Diakonova
North-West State Medical University named after I.I. Mechnikov
Email: dec.dmn@gmail.com
ORCID iD: 0009-0005-7514-5647
SPIN-code: 9270-6781
MD
Russian Federation, Saint PetersburgElena S. Pavlyuchenko
North-West State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: Elena.Pavlyuchenko@szgmu.ru
ORCID iD: 0000-0001-7196-7866
SPIN-code: 7123-1626
MD
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Aleksandr A. Mirsaitov
North-West State Medical University named after I.I. Mechnikov
Email: aleksandr.mirsaitov@gmail.com
ORCID iD: 0000-0001-9204-6441
SPIN-code: 7708-5592
MD
Russian Federation, Saint PetersburgRoman Ya. Byrsan
North-West State Medical University named after I.I. Mechnikov
Email: byrsanroma@mail.ru
ORCID iD: 0009-0000-7665-2011
MD
Russian Federation, Saint PetersburgElena E. Leenman
North-West State Medical University named after I.I. Mechnikov
Email: Elena.Leenman@szgmu.ru
ORCID iD: 0009-0005-0363-9197
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgIrina A. Bekhtereva
North-West State Medical University named after I.I. Mechnikov
Email: Irina.Bekhtereva@szgmu.ru
ORCID iD: 0000-0002-5206-3367
SPIN-code: 3954-2873
MD, Dr. Sci. (Medicine)
Russian Federation, Saint PetersburgEkaterina A. Liz
North-West State Medical University named after I.I. Mechnikov
Email: Xloamelinliz@mail.ru
ORCID iD: 0009-0002-9656-9295
MD
Russian Federation, Saint PetersburgVadim I. Mazurov
North-West State Medical University named after I.I. Mechnikov
Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482
MD, Dr. Sci. (Medicine), Professor, Academician of the RAS, Honored Scientist of the Russian Federation
Russian Federation, Saint PetersburgReferences
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