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Penny

Sjögren's and Lymphoma

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Hello, all,

 

It was not too long ago that I found out I had Sjögren's and I am particularly worried about the connection between it and Lymphoma, for a very good reason.

 

The last time I saw my primary care doctor (PC), which was pre-Sjögren's diagnosis, I pointed out some lymph nodes on the front of my shoulder (just past the crook of my underarm) that have been hard, enlarged and painless for 8 months. They do not move around and seem to be firmly attached to the tissue under them. They are not huge (2 are about 1cm, the other 1 and 1/2 cm) and completely painless. He pressed on them a bit then asked when my last mammogram was, which stunned me since I have no lumps there at all. Then he said "get a mammogram" and left it at that. I tracked down where to get one and got it, and it was clear, so I chalked it up to the 'nothing to worry about" category since he was not worried.

 

I have since done many detailed searches online and I can't find anything on hard painless lymph nodes except for lymphoma sites, but once more, I figured that if my PC was not worried I would not be either. Then I was told I have Sjögren's. Now I am worried.

 

I know I need to find a new PC, he is an Internist and is a very nice person, but he just does not seem to be taking me seriously but for right now I really need to hear some ideas as to what I am looking at and what to prepare for.

 

Thanks for any help,

 

Penny

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Hi Penny,

 

I ended up printing out about a ton of scholarly articles regarding my own particular autoimmune issues, organizing them very carefully into a large, indexed notebook (with a copy for me) and then presenting it to my general practitioner. I did smile and then say "Read and learn! I know I'm likely to be the only sclero patient you'll ever see, so I've done some research for you." (It also got rid of the lingering frustration and anger that I was feeling because he'd never managed a correct diagnosis.) I got a thanks and a big hug and got to keep a general practitioner I did like for 'ordinary' things.

 

Although my reading indicates that there is a higher than normal incidence of lymphoma in Sjögren's patients, it seems that only 5% will develop a lymphoid malignancy (which, of course, could occur just about anywhere). Other factors which increase the risk are certain medications, especially immunosuppressants. I get my blood work done monthly - you probably do too. It's my understanding there would be anomalies there if you had a lymphoma going on.

 

The site of your hardened nodes would generally be included in a good mammogram film; that could be why your general practitioner ordered one. Do you think he'd be open to a request for further investigation of the nodes? Wouldn't do any harm to ask.

 

Best wishes,


Jeannie McClelland

(Retired) ISN Director of Support Services

(Retired) ISN Sclero Forums Manager

(Retired) ISN Blog Manager

(Retired) ISN Assistant News Guide

(Retired) ISN Artist

International Scleroderma Network

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I have recently been diagnosed with Sjogren's (within the last year) but have not had anyone mention a correlation with lymphoma. I will ask my rheumatologist his thoughts the next time I visit as my father passed with non-Hodgkins lymphoma a few years ago.


I may have Scleroderma, but Scleroderma doesn't have me!

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Hi Penny,

 

It sounds like it would be worthwhile to go back to him with the Sjogren's diagnosis, and the mammogram results, have him examine the nodes again, and ask him what the next step would be. (Or, go to a new doctor, your pick, of course.) I tend to think he was thinking they might show up on a mammogram, but since they didn't, you might need other or more precise evaluation.

 

We have several references to lymphoma on our Sjogren's page. In particular,

 

Hepatitis C virus, Sjogren's syndrome and B-cell lymphoma: linking infection, autoimmunity and cancer. Viruses have been proposed as possible etiologic or triggering agents of systemic autoimmune diseases, with hepatitis C being one most frequently associated with autoimmune features and with systemic autoimmunes such as mixed cryoglobulinemia or Sjogren's Syndrome. Association between HCV infection and hematologic malignancies, mainly non-Hodgkin's lymphoma, is supported by several studies. PubMed. Autoimmun Rev. 2005 Jan;4(1):8-15. (Also see: Liver Involvement, Cancer and Scleroderma, and Causes of Scleroderma: Infection)


Warm Hugs,

 

Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099

 

The most important thing in the world to know about scleroderma is sclero.org.

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