Rheumatology: Sjogren syndrome complications: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Rheumatology: Sjogren syndrome complications

Sample item

A 54-year-old woman with long-standing primary Sjogren syndrome develops persistent unilateral parotid enlargement, palpable purpura and a low C4. Which complication should be suspected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Marginal zone B-cell non-Hodgkin lymphoma

Primary Sjogren syndrome carries a risk of B-cell lymphoma, usually extranodal marginal zone (MALT) lymphoma of the salivary glands. Persistent parotid swelling, palpable purpura, low C4 and cryoglobulinaemia identify higher risk. Biopsy of the enlarged gland establishes the diagnosis.

Option by option

  • A. Marginal zone B-cell non-Hodgkin lymphoma (correct)

    Correct. Chronic B-cell stimulation predisposes to marginal zone lymphoma.

  • B. T-cell lymphoma of the skin

    Cutaneous T-cell lymphoma is not associated with Sjogren syndrome.

  • C. Hodgkin lymphoma

    Hodgkin lymphoma is not the characteristic malignancy of Sjogren syndrome.

  • D. Multiple myeloma

    Myeloma presents with bone pain, anaemia and renal failure and is not linked to purpura with parotid swelling here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Marginal zone B-cell non-Hodgkin lymphoma. Primary Sjogren syndrome carries a risk of B-cell lymphoma, usually extranodal marginal zone (MALT) lymphoma of the salivary glands.

Why is "T-cell lymphoma of the skin" not the answer?

Cutaneous T-cell lymphoma is not associated with Sjogren syndrome.

Why is "Hodgkin lymphoma" not the answer?

Hodgkin lymphoma is not the characteristic malignancy of Sjogren syndrome.

Why is "Multiple myeloma" not the answer?

Myeloma presents with bone pain, anaemia and renal failure and is not linked to purpura with parotid swelling here.

What concept does this question test?

It tests Rheumatology: Sjogren syndrome complications in General Medicine. Persistent parotid swelling, palpable purpura, low C4 and cryoglobulinaemia identify higher risk. Biopsy of the enlarged gland establishes the diagnosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Rheumatology: Sjogren syndrome complications?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.