Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease

<!DOCTYPE html> <html lang="en" xmlns:og="http://ogp.me/ns#" xmlns:fb="https://www.facebook.com/2008/fbml"> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"> <meta content="mdpi" name="sso-service" /> <meta content="width=device-width, initial-scale=1.0" name="viewport" /> <title>Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren&rsquo;s Disease</title><link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/font-awesome.min.css?eb190a3a77e5e1ee?1733310352"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/jquery.multiselect.css?f56c135cbf4d1483?1733310352"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/chosen.min.css?d7ca5ca9441ef9e1?1733310352"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/main2.css?69b39374e6b554b7?1733310352"> <link rel="mask-icon" href="https://pub.mdpi-res.com/img/mask-icon-128.svg?c1c7eca266cd7013?1733310352" color="#4f5671"> <link rel="apple-touch-icon" sizes="180x180" href="https://pub.mdpi-res.com/icon/apple-touch-icon-180x180.png?1733310352"> <link rel="apple-touch-icon" sizes="152x152" href="https://pub.mdpi-res.com/icon/apple-touch-icon-152x152.png?1733310352"> <link rel="apple-touch-icon" sizes="144x144" href="https://pub.mdpi-res.com/icon/apple-touch-icon-144x144.png?1733310352"> <link rel="apple-touch-icon" sizes="120x120" href="https://pub.mdpi-res.com/icon/apple-touch-icon-120x120.png?1733310352"> <link rel="apple-touch-icon" sizes="114x114" href="https://pub.mdpi-res.com/icon/apple-touch-icon-114x114.png?1733310352"> <link rel="apple-touch-icon" sizes="76x76" href="https://pub.mdpi-res.com/icon/apple-touch-icon-76x76.png?1733310352"> <link rel="apple-touch-icon" sizes="72x72" href="https://pub.mdpi-res.com/icon/apple-touch-icon-72x72.png?1733310352"> <link rel="apple-touch-icon" sizes="57x57" href="https://pub.mdpi-res.com/icon/apple-touch-icon-57x57.png?1733310352"> <link rel="apple-touch-icon" href="https://pub.mdpi-res.com/icon/apple-touch-icon-57x57.png?1733310352"> <link rel="apple-touch-icon-precomposed" href="https://pub.mdpi-res.com/icon/apple-touch-icon-57x57.png?1733310352"> <link rel="manifest" href="/manifest.json"> <meta name="theme-color" content="#ffffff"> <meta name="application-name" content=" "/> <link rel="apple-touch-startup-image" href="https://pub.mdpi-res.com/img/journals/rheumato-logo-sq.png?fc246099e5001501"> <link rel="apple-touch-icon" href="https://pub.mdpi-res.com/img/journals/rheumato-logo-sq.png?fc246099e5001501"> <meta name="msapplication-TileImage" content="https://pub.mdpi-res.com/img/journals/rheumato-logo-sq.png?fc246099e5001501"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/jquery-ui-1.10.4.custom.min.css?80647d88647bf347?1733310352"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/magnific-popup.min.css?04d343e036f8eecd?1733310352"> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/xml2html/article-html.css?230b005b39af4260?1733310352"> <style> h2, #abstract .related_suggestion_title { } .batch_articles a { color: #000; } a, .batch_articles .authors a, a:focus, a:hover, a:active, .batch_articles a:focus, .batch_articles a:hover, li.side-menu-li a { } span.label a { color: #fff; } #main-content a.title-link:hover, #main-content a.title-link:focus, #main-content div.generic-item a.title-link:hover, #main-content div.generic-item a.title-link:focus { } #main-content #middle-column .generic-item.article-item a.title-link:hover, #main-content #middle-column .generic-item.article-item a.title-link:focus { } .art-authors a.toEncode { color: #333; font-weight: 700; } #main-content #middle-column ul li::before { } .accordion-navigation.active a.accordion__title, .accordion-navigation.active a.accordion__title::after { } .accordion-navigation li:hover::before, .accordion-navigation li:hover a, .accordion-navigation li:focus a { } .relative-size-container .relative-size-image .relative-size { } .middle-column__help__fixed a:hover i, } input[type="checkbox"]:checked:after { } input[type="checkbox"]:not(:disabled):hover:before { } #main-content .bolded-text { } #main-content .hypothesis-count-container { } #main-content .hypothesis-count-container:before { } .full-size-menu ul li.menu-item .dropdown-wrapper { } .full-size-menu ul li.menu-item > a.open::after { } #title-story .title-story-orbit .orbit-caption { #background: url('/img/design/000000_background.png') !important; background: url('/img/design/ffffff_background.png') !important; color: rgb(51, 51, 51) !important; } #main-content .content__container__orbit { background-color: #000 !important; } #main-content .content__container__journal { color: #fff; } .html-article-menu .row span { } .html-article-menu .row span.active { } .accordion-navigation__journal .side-menu-li.active::before, .accordion-navigation__journal .side-menu-li.active a { color: rgba(104,18,30,0.75) !important; font-weight: 700; } .accordion-navigation__journal .side-menu-li:hover::before , .accordion-navigation__journal .side-menu-li:hover a { color: rgba(104,18,30,0.75) !important; } .side-menu-ul li.active a, .side-menu-ul li.active, .side-menu-ul li.active::before { color: rgba(104,18,30,0.75) !important; } .side-menu-ul li.active a { } .result-selected, .active-result.highlighted, .active-result:hover, .result-selected, .active-result.highlighted, .active-result:focus { } .search-container.search-container__default-scheme { } nav.tab-bar .open-small-search.active:after { } .search-container.search-container__default-scheme .custom-accordion-for-small-screen-link::after { color: #fff; } @media only screen and (max-width: 50em) { #main-content .content__container.journal-info { color: #fff; } #main-content .content__container.journal-info a { color: #fff; } } .button.button--color { } .button.button--color:hover, .button.button--color:focus { } .button.button--color-journal { position: relative; background-color: rgba(104,18,30,0.75); border-color: #fff; color: #fff !important; } .button.button--color-journal:hover::before { content: ''; position: absolute; top: 0; left: 0; height: 100%; width: 100%; background-color: #ffffff; opacity: 0.2; } .button.button--color-journal:visited, .button.button--color-journal:hover, .button.button--color-journal:focus { background-color: rgba(104,18,30,0.75); border-color: #fff; color: #fff !important; } .button.button--color path { } .button.button--color:hover path { fill: #fff; } #main-content #search-refinements .ui-slider-horizontal .ui-slider-range { } .breadcrumb__element:last-of-type a { } #main-header { } #full-size-menu .top-bar, #full-size-menu li.menu-item span.user-email { } .top-bar-section li:not(.has-form) a:not(.button) { } #full-size-menu li.menu-item .dropdown-wrapper li a:hover { } #full-size-menu li.menu-item a:hover, #full-size-menu li.menu.item a:focus, nav.tab-bar a:hover { } #full-size-menu li.menu.item a:active, #full-size-menu li.menu.item a.active { } #full-size-menu li.menu-item a.open-mega-menu.active, #full-size-menu li.menu-item div.mega-menu, a.open-mega-menu.active { } #full-size-menu li.menu-item div.mega-menu li, #full-size-menu li.menu-item div.mega-menu a { border-color: #9a9a9a; } div.type-section h2 { font-size: 20px; line-height: 26px; font-weight: 300; } div.type-section h3 { margin-left: 15px; margin-bottom: 0px; font-weight: 300; } .journal-tabs .tab-title.active a { } </style> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/slick.css?f38b2db10e01b157?1733310352"> <meta name="title" content="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease"> <meta name="description" content="Sjogren’s Disease (SjD) is associated with an increased risk of lymphoma. We investigated the prevalence of lymphoma in a retrospective case series of patients with SjD and reported on the clinical presentation, treatment, response, and outcome. A retrospective review of 132 patients diagnosed with Sjogren’s Disease was conducted at our institution from June 2000 to November 2023, and 10 cases of malignant lymphoma were identified. Clinical and biological markers known to be predictors of lymphoma, as well as lymphoma characteristics, were examined. The most common predictive lab findings were hypergammaglobulinemia, the rheumatoid factor, and lymphopenia. Persistent parotid gland enlargement was also found in greater than 50% of patients. The majority of patients were Caucasian females, and the average time between the diagnosis of SjD and lymphoma was 14.3 years. The median age at lymphoma diagnosis was 59.5 years, with 9 out of 10 lymphomas identified as non-Hodgkin lymphoma, the majority of cases being mucosa-associated lymphoid tissue (MALT) lymphoma. We identified similarities in our series, such as laboratory markers and clinical symptoms, to those previously identified as possible predictors of lymphoma development. These factors may be useful in determining the risk of malignancy development and justify the need for long-term monitoring, as well as provider education and awareness." > <link rel="image_src" href="https://pub.mdpi-res.com/img/journals/rheumato-logo.png?fc246099e5001501" > <meta name="dc.title" content="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease"> <meta name="dc.creator" content="Jennifer Behbodikhah"> <meta name="dc.creator" content="Lisa Balistreri"> <meta name="dc.creator" content="Steven E. Carsons"> <meta name="dc.type" content="Article"> <meta name="dc.source" content="Rheumato 2024, Vol. 4, Pages 153-162"> <meta name="dc.date" content="2024-08-30"> <meta name ="dc.identifier" content="10.3390/rheumato4030012"> <meta name="dc.publisher" content="Multidisciplinary Digital Publishing Institute"> <meta name="dc.rights" content="http://creativecommons.org/licenses/by/3.0/"> <meta name="dc.format" content="application/pdf" > <meta name="dc.language" content="en" > <meta name="dc.description" content="Sjogren’s Disease (SjD) is associated with an increased risk of lymphoma. We investigated the prevalence of lymphoma in a retrospective case series of patients with SjD and reported on the clinical presentation, treatment, response, and outcome. A retrospective review of 132 patients diagnosed with Sjogren’s Disease was conducted at our institution from June 2000 to November 2023, and 10 cases of malignant lymphoma were identified. Clinical and biological markers known to be predictors of lymphoma, as well as lymphoma characteristics, were examined. The most common predictive lab findings were hypergammaglobulinemia, the rheumatoid factor, and lymphopenia. Persistent parotid gland enlargement was also found in greater than 50% of patients. The majority of patients were Caucasian females, and the average time between the diagnosis of SjD and lymphoma was 14.3 years. The median age at lymphoma diagnosis was 59.5 years, with 9 out of 10 lymphomas identified as non-Hodgkin lymphoma, the majority of cases being mucosa-associated lymphoid tissue (MALT) lymphoma. We identified similarities in our series, such as laboratory markers and clinical symptoms, to those previously identified as possible predictors of lymphoma development. These factors may be useful in determining the risk of malignancy development and justify the need for long-term monitoring, as well as provider education and awareness." > <meta name="dc.subject" content="Sjogren’s disease (SjD)" > <meta name="dc.subject" content="lymphoma" > <meta name="dc.subject" content="parotid gland" > <meta name ="prism.issn" content="2674-0621"> <meta name ="prism.publicationName" content="Rheumato"> <meta name ="prism.publicationDate" content="2024-08-30"> <meta name ="prism.volume" content="4"> <meta name ="prism.number" content="3"> <meta name ="prism.section" content="Article" > <meta name ="prism.startingPage" content="153" > <meta name ="prism.endingPage" content="162" > <meta name="citation_issn" content="2674-0621"> <meta name="citation_journal_title" content="Rheumato"> <meta name="citation_publisher" content="Multidisciplinary Digital Publishing Institute"> <meta name="citation_title" content="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease"> <meta name="citation_publication_date" content="2024/9"> <meta name="citation_online_date" content="2024/08/30"> <meta name="citation_volume" content="4"> <meta name="citation_issue" content="3"> <meta name="citation_firstpage" content="153"> <meta name="citation_author" content="Behbodikhah, Jennifer"> <meta name="citation_author" content="Balistreri, Lisa"> <meta name="citation_author" content="Carsons, Steven E."> <meta name ="citation_lastpage" content="162" > <meta name="citation_doi" content="10.3390/rheumato4030012"> <meta name="citation_id" content="mdpi-rheumato4030012"> <meta name="citation_abstract_html_url" content="https://www.mdpi.com/2674-0621/4/3/12"> <meta name="citation_pdf_url" content="https://www.mdpi.com/2674-0621/4/3/12/pdf?version=1726126250"> <link rel="alternate" type="application/pdf" title="PDF Full-Text" href="https://www.mdpi.com/2674-0621/4/3/12/pdf?version=1726126250"> <meta name="fulltext_pdf" content="https://www.mdpi.com/2674-0621/4/3/12/pdf?version=1726126250"> <meta name="citation_fulltext_html_url" content="https://www.mdpi.com/2674-0621/4/3/12/htm"> <link rel="alternate" type="text/html" title="HTML Full-Text" href="https://www.mdpi.com/2674-0621/4/3/12/htm"> <meta name="fulltext_html" content="https://www.mdpi.com/2674-0621/4/3/12/htm"> <link rel="alternate" type="text/xml" title="XML Full-Text" href="https://www.mdpi.com/2674-0621/4/3/12/xml"> <meta name="fulltext_xml" content="https://www.mdpi.com/2674-0621/4/3/12/xml"> <meta name="citation_xml_url" content="https://www.mdpi.com/2674-0621/4/3/12/xml"> <meta name="twitter:card" content="summary" /> <meta name="twitter:site" content="@MDPIOpenAccess" /> <meta name="twitter:image" content="https://pub.mdpi-res.com/img/journals/rheumato-logo-social.png?fc246099e5001501" /> <meta property="fb:app_id" content="131189377574"/> <meta property="og:site_name" content="MDPI"/> <meta property="og:type" content="article"/> <meta property="og:url" content="https://www.mdpi.com/2674-0621/4/3/12" /> <meta property="og:title" content="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease" /> <meta property="og:description" content="Sjogren’s Disease (SjD) is associated with an increased risk of lymphoma. We investigated the prevalence of lymphoma in a retrospective case series of patients with SjD and reported on the clinical presentation, treatment, response, and outcome. A retrospective review of 132 patients diagnosed with Sjogren’s Disease was conducted at our institution from June 2000 to November 2023, and 10 cases of malignant lymphoma were identified. Clinical and biological markers known to be predictors of lymphoma, as well as lymphoma characteristics, were examined. The most common predictive lab findings were hypergammaglobulinemia, the rheumatoid factor, and lymphopenia. Persistent parotid gland enlargement was also found in greater than 50% of patients. The majority of patients were Caucasian females, and the average time between the diagnosis of SjD and lymphoma was 14.3 years. The median age at lymphoma diagnosis was 59.5 years, with 9 out of 10 lymphomas identified as non-Hodgkin lymphoma, the majority of cases being mucosa-associated lymphoid tissue (MALT) lymphoma. We identified similarities in our series, such as laboratory markers and clinical symptoms, to those previously identified as possible predictors of lymphoma development. These factors may be useful in determining the risk of malignancy development and justify the need for long-term monitoring, as well as provider education and awareness." /> <meta property="og:image" content="https://pub.mdpi-res.com/img/journals/rheumato-logo-social.png?fc246099e5001501" /> <link rel="alternate" type="application/rss+xml" title="MDPI Publishing - Latest articles" href="https://www.mdpi.com/rss"> <meta name="google-site-verification" content="PxTlsg7z2S00aHroktQd57fxygEjMiNHydKn3txhvwY"> <meta name="facebook-domain-verification" content="mcoq8dtq6sb2hf7z29j8w515jjoof7" /> <script id="Cookiebot" data-cfasync="false" src="https://consent.cookiebot.com/uc.js" data-cbid="51491ddd-fe7a-4425-ab39-69c78c55829f" type="text/javascript" async></script>  <script type="text/plain" data-cookieconsent="statistics"> (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-WPK7SW5'); </script> <script type="text/plain" data-cookieconsent="statistics"> _linkedin_partner_id = "2846186"; window._linkedin_data_partner_ids = window._linkedin_data_partner_ids || []; window._linkedin_data_partner_ids.push(_linkedin_partner_id); </script><script type="text/javascript"> (function(){var s = document.getElementsByTagName("script")[0]; var b = document.createElement("script"); b.type = "text/javascript";b.async = true; b.src = "https://snap.licdn.com/li.lms-analytics/insight.min.js"; s.parentNode.insertBefore(b, s);})(); </script> <script type="text/plain" data-cookieconsent="statistics" data-cfasync="false" src="//script.crazyegg.com/pages/scripts/0116/4951.js" async="async" ></script> </head> <body> <div class="direction direction_right" id="small_right" style="border-right-width: 0px; padding:0;"> <i class="fa fa-caret-right fa-2x"></i> </div> <div class="big_direction direction_right" id="big_right" style="border-right-width: 0px;"> <div style="text-align: right;"> Next Article in Journal<br> <div><a href="/2674-0621/4/4/13"><i>IL-11</i> Expression in Systemic Sclerosis Is Dependent on Caspase-1 Activity but Does Not Increase Collagen Deposition</a></div> </div> </div> <div class="direction" id="small_left" style="border-left-width: 0px"> <i class="fa fa-caret-left fa-2x"></i> </div> <div class="big_direction" id="big_left" style="border-left-width: 0px;"> <div> Previous Article in Journal<br> <div><a href="/2674-0621/4/3/11">Fibromyalgia: Hamlet’s Soliloquy and the State of the Art</a></div> </div> </div> <div style="clear: both;"></div> <div id="menuModal" class="reveal-modal reveal-modal-new reveal-modal-menu" aria-hidden="true" data-reveal role="dialog"> <div class="menu-container"> <div class="UI_NavMenu"> <div class="content__container " > <div class="custom-accordion-for-small-screen-link " > <h2>Journals</h2> </div> <div class="target-item custom-accordion-for-small-screen-content show-for-medium-up"> <div class="menu-container__links"> <div style="width: 100%; float: left;"> <a href="/about/journals">Active Journals</a> <a href="/about/journalfinder">Find a Journal</a> <a href="/about/journals/proposal">Journal Proposal</a> <a href="/about/proceedings">Proceedings Series</a> </div> </div> </div> </div> <a href="/topics"> <h2>Topics</h2> </a> <div class="content__container " > <div class="custom-accordion-for-small-screen-link " > <h2>Information</h2> </div> <div class="target-item custom-accordion-for-small-screen-content show-for-medium-up"> <div class="menu-container__links"> <div style="width: 100%; max-width: 200px; float: left;"> <a href="/authors">For Authors</a> <a href="/reviewers">For Reviewers</a> <a href="/editors">For Editors</a> <a href="/librarians">For Librarians</a> <a href="/publishing_services">For Publishers</a> <a href="/societies">For Societies</a> <a href="/conference_organizers">For Conference Organizers</a> </div> <div style="width: 100%; max-width: 250px; float: left;"> <a href="/openaccess">Open Access Policy</a> <a href="/ioap">Institutional Open Access Program</a> <a href="/special_issues_guidelines">Special Issues Guidelines</a> <a href="/editorial_process">Editorial Process</a> <a href="/ethics">Research and Publication Ethics</a> <a href="/apc">Article Processing Charges</a> <a href="/awards">Awards</a> <a href="/testimonials">Testimonials</a> </div> </div> </div> </div> <a href="/authors/english"> <h2>Editing Services</h2> </a> <div class="content__container " > <div class="custom-accordion-for-small-screen-link " > <h2>Initiatives</h2> </div> <div class="target-item custom-accordion-for-small-screen-content show-for-medium-up"> <div class="menu-container__links"> <div style="width: 100%; float: left;"> <a href="https://sciforum.net" target="_blank" rel="noopener noreferrer">Sciforum</a> <a href="https://www.mdpi.com/books" target="_blank" rel="noopener noreferrer">MDPI Books</a> <a href="https://www.preprints.org" target="_blank" rel="noopener noreferrer">Preprints.org</a> <a href="https://www.scilit.net" target="_blank" rel="noopener noreferrer">Scilit</a> <a href="https://sciprofiles.com" target="_blank" rel="noopener noreferrer">SciProfiles</a> <a href="https://encyclopedia.pub" target="_blank" rel="noopener noreferrer">Encyclopedia</a> <a href="https://jams.pub" target="_blank" rel="noopener noreferrer">JAMS</a> <a href="/about/proceedings">Proceedings Series</a> </div> </div> </div> </div> <div class="content__container " > <div class="custom-accordion-for-small-screen-link " > <h2>About</h2> </div> <div class="target-item custom-accordion-for-small-screen-content show-for-medium-up"> <div class="menu-container__links"> <div style="width: 100%; float: left;"> <a href="/about">Overview</a> <a href="/about/contact">Contact</a> <a href="https://careers.mdpi.com" target="_blank" rel="noopener noreferrer">Careers</a> <a href="/about/announcements">News</a> <a href="/about/press">Press</a> <a href="http://blog.mdpi.com/" target="_blank" rel="noopener noreferrer">Blog</a> </div> </div> </div> </div> </div> <div class="menu-container__buttons"> <a class="button UA_SignInUpButton" href="/user/login">Sign In / Sign Up</a> </div> </div> </div> <div id="captchaModal" class="reveal-modal reveal-modal-new reveal-modal-new--small" data-reveal aria-label="Captcha" aria-hidden="true" role="dialog"></div> <div id="actionDisabledModal" class="reveal-modal" data-reveal aria-labelledby="actionDisableModalTitle" aria-hidden="true" role="dialog" style="width: 300px;"> <h2 id="actionDisableModalTitle">Notice</h2> <form action="/email/captcha" method="post" id="emailCaptchaForm"> <div class="row"> <div id="js-action-disabled-modal-text" class="small-12 columns"> </div> <div id="js-action-disabled-modal-submit" class="small-12 columns" style="margin-top: 10px; display: none;"> You can make submissions to other journals <a href="https://susy.mdpi.com/user/manuscripts/upload">here</a>. </div> </div> </form> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> <div id="rssNotificationModal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="rssNotificationModalTitle" aria-hidden="true" role="dialog"> <div class="row"> <div class="small-12 columns"> <h2 id="rssNotificationModalTitle">Notice</h2> <p> You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader. </p> </div> </div> <div class="row"> <div class="small-12 columns"> <a class="button button--color js-rss-notification-confirm">Continue</a> <a class="button button--grey" onclick="$(this).closest('.reveal-modal').find('.close-reveal-modal').click(); return false;">Cancel</a> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> <div id="drop-article-label-openaccess" class="f-dropdown medium" data-dropdown-content aria-hidden="true" tabindex="-1"> <p> All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to <a href="https://www.mdpi.com/openaccess">https://www.mdpi.com/openaccess</a>. </p> </div> <div id="drop-article-label-feature" class="f-dropdown medium" data-dropdown-content aria-hidden="true" tabindex="-1"> <p> Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications. </p> <p> Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers. </p> </div> <div id="drop-article-label-choice" class="f-dropdown medium" data-dropdown-content aria-hidden="true" tabindex="-1"> <p> Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal. <div style="margin-top: -10px;"> <div id="drop-article-label-choice-journal-link" style="display: none; margin-top: -10px; padding-top: 10px;"> </div> </div> </p> </div> <div id="drop-article-label-resubmission" class="f-dropdown medium" data-dropdown-content aria-hidden="true" tabindex="-1"> <p> Original Submission Date Received: <span id="drop-article-label-resubmission-date"></span>. </p> </div> <div id="container"> <noscript> <div id="no-javascript"> You seem to have javascript disabled. Please note that many of the page functionalities won't work as expected without javascript enabled. </div> </noscript> <div class="fixed"> <nav class="tab-bar show-for-medium-down"> <div class="row full-width collapse"> <div class="medium-3 small-4 columns"> <a href="/"> <img class="full-size-menu__mdpi-logo" src="https://pub.mdpi-res.com/img/design/mdpi-pub-logo-black-small1.svg?da3a8dcae975a41c?1733310352" style="width: 64px;" title="MDPI Open Access Journals"> </a> </div> <div class="medium-3 small-4 columns right-aligned"> <div class="show-for-medium-down"> <a href="#" style="display: none;"> <i class="material-icons" onclick="$('#menuModal').foundation('reveal', 'close'); return false;">clear</i> </a> <a class="js-toggle-desktop-layout-link" title="Toggle desktop layout" style="display: none;" href="/toggle_desktop_layout_cookie"> <i class="material-icons">zoom_out_map</i> </a> <a href="#" class="js-open-small-search open-small-search"> <i class="material-icons show-for-small only">search</i> </a> <a title="MDPI main page" class="js-open-menu" data-reveal-id="menuModal" href="#"> <i class="material-icons">menu</i> </a> </div> </div> </div> </nav> </div> <section class="main-section"> <header> <div class="full-size-menu show-for-large-up"> <div class="row full-width"> <div class="large-1 columns"> <a href="/"> <img class="full-size-menu__mdpi-logo" src="https://pub.mdpi-res.com/img/design/mdpi-pub-logo-black-small1.svg?da3a8dcae975a41c?1733310352" title="MDPI Open Access Journals"> </a> </div> <div class="large-8 columns text-right UI_NavMenu"> <ul> <li class="menu-item"> <a href="/about/journals" data-dropdown="journals-dropdown" aria-controls="journals-dropdown" aria-expanded="false" data-options="is_hover: true; hover_timeout: 200">Journals</a> <ul id="journals-dropdown" class="f-dropdown dropdown-wrapper dropdown-wrapper__small" data-dropdown-content aria-hidden="true" tabindex="-1"> <li> <div class="row"> <div class="small-12 columns"> <ul> <li> <a href="/about/journals"> Active Journals </a> </li> <li> <a href="/about/journalfinder"> Find a Journal </a> </li> <li> <a href="/about/journals/proposal"> Journal Proposal </a> </li> <li> <a href="/about/proceedings"> Proceedings Series </a> </li> </ul> </div> </div> </li> </ul> </li> <li class="menu-item"> <a href="/topics">Topics</a> </li> <li class="menu-item"> <a href="/authors" data-dropdown="information-dropdown" aria-controls="information-dropdown" aria-expanded="false" data-options="is_hover:true; hover_timeout:200">Information</a> <ul id="information-dropdown" class="f-dropdown dropdown-wrapper" data-dropdown-content aria-hidden="true" tabindex="-1"> <li> <div class="row"> <div class="small-5 columns right-border"> <ul> <li> <a href="/authors">For Authors</a> </li> <li> <a href="/reviewers">For Reviewers</a> </li> <li> <a href="/editors">For Editors</a> </li> <li> <a href="/librarians">For Librarians</a> </li> <li> <a href="/publishing_services">For Publishers</a> </li> <li> <a href="/societies">For Societies</a> </li> <li> <a href="/conference_organizers">For Conference Organizers</a> </li> </ul> </div> <div class="small-7 columns"> <ul> <li> <a href="/openaccess">Open Access Policy</a> </li> <li> <a href="/ioap">Institutional Open Access Program</a> </li> <li> <a href="/special_issues_guidelines">Special Issues Guidelines</a> </li> <li> <a href="/editorial_process">Editorial Process</a> </li> <li> <a href="/ethics">Research and Publication Ethics</a> </li> <li> <a href="/apc">Article Processing Charges</a> </li> <li> <a href="/awards">Awards</a> </li> <li> <a href="/testimonials">Testimonials</a> </li> </ul> </div> </div> </li> </ul> </li> <li class="menu-item"> <a href="/authors/english">Editing Services</a> </li> <li class="menu-item"> <a href="/about/initiatives" data-dropdown="initiatives-dropdown" aria-controls="initiatives-dropdown" aria-expanded="false" data-options="is_hover: true; hover_timeout: 200">Initiatives</a> <ul id="initiatives-dropdown" class="f-dropdown dropdown-wrapper dropdown-wrapper__small" data-dropdown-content aria-hidden="true" tabindex="-1"> <li> <div class="row"> <div class="small-12 columns"> <ul> <li> <a href="https://sciforum.net" target="_blank" rel="noopener noreferrer"> Sciforum </a> </li> <li> <a href="https://www.mdpi.com/books" target="_blank" rel="noopener noreferrer"> MDPI Books </a> </li> <li> <a href="https://www.preprints.org" target="_blank" rel="noopener noreferrer"> Preprints.org </a> </li> <li> <a href="https://www.scilit.net" target="_blank" rel="noopener noreferrer"> Scilit </a> </li> <li> <a href="https://sciprofiles.com" target="_blank" rel="noopener noreferrer"> SciProfiles </a> </li> <li> <a href="https://encyclopedia.pub" target="_blank" rel="noopener noreferrer"> Encyclopedia </a> </li> <li> <a href="https://jams.pub" target="_blank" rel="noopener noreferrer"> JAMS </a> </li> <li> <a href="/about/proceedings"> Proceedings Series </a> </li> </ul> </div> </div> </li> </ul> </li> <li class="menu-item"> <a href="/about" data-dropdown="about-dropdown" aria-controls="about-dropdown" aria-expanded="false" data-options="is_hover: true; hover_timeout: 200">About</a> <ul id="about-dropdown" class="f-dropdown dropdown-wrapper dropdown-wrapper__small" data-dropdown-content aria-hidden="true" tabindex="-1"> <li> <div class="row"> <div class="small-12 columns"> <ul> <li> <a href="/about"> Overview </a> </li> <li> <a href="/about/contact"> Contact </a> </li> <li> <a href="https://careers.mdpi.com" target="_blank" rel="noopener noreferrer"> Careers </a> </li> <li> <a href="/about/announcements"> News </a> </li> <li> <a href="/about/press"> Press </a> </li> <li> <a href="http://blog.mdpi.com/" target="_blank" rel="noopener noreferrer"> Blog </a> </li> </ul> </div> </div> </li> </ul> </li> </ul> </div> <div class="large-3 columns text-right full-size-menu__buttons"> <div> <a class="button button--default-inversed UA_SignInUpButton" href="/user/login">Sign In / Sign Up</a> <a class="button button--default js-journal-active-only-link js-journal-active-only-submit-link UC_NavSubmitButton" href=" https://susy.mdpi.com/user/manuscripts/upload?journal=rheumato " data-disabledmessage="new submissions are not possible.">Submit</a> </div> </div> </div> </div> <div class="header-divider"> </div> <div class="search-container hide-for-small-down row search-container__homepage-scheme"> <form id="basic_search" style="background-color: inherit !important;" class="large-12 medium-12 columns " action="/search" method="get"> <div class="row search-container__main-elements"> <div class="large-2 medium-2 small-12 columns text-right1 small-only-text-left"> <div class="show-for-medium-up"> <div class="search-input-label"> </div> </div> <span class="search-container__title">Search<span class="hide-for-medium"> for Articles</span><span class="hide-for-small">:</span></span> </div> <div class="custom-accordion-for-small-screen-content"> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Title / Keyword</div> </div> <input type="text" placeholder="Title / Keyword" id="q" tabindex="1" name="q" value="" /> </div> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Author / Affiliation / Email</div> </div> <input type="text" id="authors" placeholder="Author / Affiliation / Email" tabindex="2" name="authors" value="" /> </div> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Journal</div> </div> <select id="journal" tabindex="3" name="journal" class="chosen-select"> <option value="">All Journals</option> <option value="acoustics" > Acoustics </option> <option value="amh" > Acta Microbiologica Hellenica (AMH) </option> <option value="actuators" > Actuators </option> <option value="admsci" > Administrative Sciences </option> <option value="adolescents" > Adolescents </option> <option value="arm" > Advances in Respiratory Medicine (ARM) </option> <option value="aerobiology" > Aerobiology </option> <option value="aerospace" > Aerospace </option> <option value="agriculture" > Agriculture </option> <option value="agriengineering" > AgriEngineering </option> <option value="agrochemicals" > Agrochemicals </option> <option value="agronomy" > Agronomy </option> <option value="ai" > AI </option> <option value="air" > Air </option> <option value="algorithms" > Algorithms </option> <option value="allergies" > Allergies </option> <option value="alloys" > Alloys </option> <option value="analytica" > Analytica </option> <option value="analytics" > Analytics </option> <option value="anatomia" > Anatomia </option> <option value="anesthres" > Anesthesia Research </option> <option value="animals" > Animals </option> <option value="antibiotics" > Antibiotics </option> <option value="antibodies" > Antibodies </option> <option value="antioxidants" > Antioxidants </option> <option value="applbiosci" > Applied Biosciences </option> <option value="applmech" > Applied Mechanics </option> <option value="applmicrobiol" > Applied Microbiology </option> <option value="applnano" > Applied Nano </option> <option value="applsci" > Applied Sciences </option> <option value="asi" > Applied System Innovation (ASI) </option> <option value="appliedchem" > AppliedChem </option> <option value="appliedmath" > AppliedMath </option> <option value="aquacj" > Aquaculture Journal </option> <option value="architecture" > Architecture </option> <option value="arthropoda" > Arthropoda </option> <option value="arts" > Arts </option> <option value="astronomy" > Astronomy </option> <option value="atmosphere" > Atmosphere </option> <option value="atoms" > Atoms </option> <option value="audiolres" > Audiology Research </option> <option value="automation" > Automation </option> <option value="axioms" > Axioms </option> <option value="bacteria" > Bacteria </option> <option value="batteries" > Batteries </option> <option value="behavsci" > Behavioral Sciences </option> <option value="beverages" > Beverages </option> <option value="BDCC" > Big Data and Cognitive Computing (BDCC) </option> <option value="biochem" > BioChem </option> <option value="bioengineering" > Bioengineering </option> <option value="biologics" > Biologics </option> <option value="biology" > Biology </option> <option value="blsf" > Biology and Life Sciences Forum </option> <option value="biomass" > Biomass </option> <option value="biomechanics" > Biomechanics </option> <option value="biomed" > BioMed </option> <option value="biomedicines" > Biomedicines </option> <option value="biomedinformatics" > BioMedInformatics </option> <option value="biomimetics" > Biomimetics </option> <option value="biomolecules" > Biomolecules </option> <option value="biophysica" > Biophysica </option> <option value="biosensors" > Biosensors </option> <option value="biotech" > BioTech </option> <option value="birds" > Birds </option> <option value="blockchains" > Blockchains </option> <option value="brainsci" > Brain Sciences </option> <option value="buildings" > Buildings </option> <option value="businesses" > Businesses </option> <option value="carbon" > C </option> <option value="cancers" > Cancers </option> <option value="cardiogenetics" > Cardiogenetics </option> <option value="catalysts" > Catalysts </option> <option value="cells" > Cells </option> <option value="ceramics" > Ceramics </option> <option value="challenges" > Challenges </option> <option value="ChemEngineering" > ChemEngineering </option> <option value="chemistry" > Chemistry </option> <option value="chemproc" > Chemistry Proceedings </option> <option value="chemosensors" > Chemosensors </option> <option value="children" > Children </option> <option value="chips" > Chips </option> <option value="civileng" > CivilEng </option> <option value="cleantechnol" > Clean Technologies (Clean Technol.) </option> <option value="climate" > Climate </option> <option value="ctn" > Clinical and Translational Neuroscience (CTN) </option> <option value="clinbioenerg" > Clinical Bioenergetics </option> <option value="clinpract" > Clinics and Practice </option> <option value="clockssleep" > Clocks & Sleep </option> <option value="coasts" > Coasts </option> <option value="coatings" > Coatings </option> <option value="colloids" > Colloids and Interfaces </option> <option value="colorants" > Colorants </option> <option value="commodities" > Commodities </option> <option value="complications" > Complications </option> <option value="compounds" > Compounds </option> <option value="computation" > Computation </option> <option value="csmf" > Computer Sciences & Mathematics Forum </option> <option value="computers" > Computers </option> <option value="condensedmatter" > Condensed Matter </option> <option value="conservation" > Conservation </option> <option value="constrmater" > Construction Materials </option> <option value="cmd" > Corrosion and Materials Degradation (CMD) </option> <option value="cosmetics" > Cosmetics </option> <option value="covid" > COVID </option> <option value="crops" > Crops </option> <option value="cryo" > Cryo </option> <option value="cryptography" > Cryptography </option> <option value="crystals" > Crystals </option> <option value="cimb" > Current Issues in Molecular Biology (CIMB) </option> <option value="curroncol" > Current Oncology </option> <option value="dairy" > Dairy </option> <option value="data" > Data </option> <option value="dentistry" > Dentistry Journal </option> <option value="dermato" > Dermato </option> <option value="dermatopathology" > Dermatopathology </option> <option value="designs" > Designs </option> <option value="diabetology" > Diabetology </option> <option value="diagnostics" > Diagnostics </option> <option value="dietetics" > Dietetics </option> <option value="digital" > Digital </option> <option value="disabilities" > Disabilities </option> <option value="diseases" > Diseases </option> <option value="diversity" > Diversity </option> <option value="dna" > DNA </option> <option value="drones" > Drones </option> <option value="ddc" > Drugs and Drug Candidates (DDC) </option> <option value="dynamics" > Dynamics </option> <option value="earth" > Earth </option> <option value="ecologies" > Ecologies </option> <option value="econometrics" > Econometrics </option> <option value="economies" > Economies </option> <option value="education" > Education Sciences </option> <option value="electricity" > Electricity </option> <option value="electrochem" > Electrochem </option> <option value="electronicmat" > Electronic Materials </option> <option value="electronics" > Electronics </option> <option value="ecm" > Emergency Care and Medicine </option> <option value="encyclopedia" > Encyclopedia </option> <option value="endocrines" > Endocrines </option> <option value="energies" > Energies </option> <option value="esa" > Energy Storage and Applications (ESA) </option> <option value="eng" > Eng </option> <option value="engproc" > Engineering Proceedings </option> <option value="entropy" > Entropy </option> <option value="eesp" > Environmental and Earth Sciences Proceedings </option> <option value="environments" > Environments </option> <option value="epidemiologia" > Epidemiologia </option> <option value="epigenomes" > Epigenomes </option> <option value="ebj" > European Burn Journal (EBJ) </option> <option value="ejihpe" > European Journal of Investigation in Health, Psychology and Education (EJIHPE) </option> <option value="fermentation" > Fermentation </option> <option value="fibers" > Fibers </option> <option value="fintech" > FinTech </option> <option value="fire" > Fire </option> <option value="fishes" > Fishes </option> <option value="fluids" > Fluids </option> <option value="foods" > Foods </option> <option value="forecasting" > Forecasting </option> <option value="forensicsci" > Forensic Sciences </option> <option value="forests" > Forests </option> <option value="fossstud" > Fossil Studies </option> <option value="foundations" > Foundations </option> <option value="fractalfract" > Fractal and Fractional (Fractal Fract) </option> <option value="fuels" > Fuels </option> <option value="future" > Future </option> <option value="futureinternet" > Future Internet </option> <option value="futurepharmacol" > Future Pharmacology </option> <option value="futuretransp" > Future Transportation </option> <option value="galaxies" > Galaxies </option> <option value="games" > Games </option> <option value="gases" > Gases </option> <option value="gastroent" > Gastroenterology Insights </option> <option value="gastrointestdisord" > Gastrointestinal Disorders </option> <option value="gastronomy" > Gastronomy </option> <option value="gels" > Gels </option> <option value="genealogy" > Genealogy </option> <option value="genes" > Genes </option> <option value="geographies" > Geographies </option> <option value="geohazards" > GeoHazards </option> <option value="geomatics" > Geomatics </option> <option value="geometry" > Geometry </option> <option value="geosciences" > Geosciences </option> <option value="geotechnics" > Geotechnics </option> <option value="geriatrics" > Geriatrics </option> <option value="glacies" > Glacies </option> <option value="gucdd" > Gout, Urate, and Crystal Deposition Disease (GUCDD) </option> <option value="grasses" > Grasses </option> <option value="hardware" > Hardware </option> <option value="healthcare" > Healthcare </option> <option value="hearts" > Hearts </option> <option value="hemato" > Hemato </option> <option value="hematolrep" > Hematology Reports </option> <option value="heritage" > Heritage </option> <option value="histories" > Histories </option> <option value="horticulturae" > Horticulturae </option> <option value="hospitals" > Hospitals </option> <option value="humanities" > Humanities </option> <option value="humans" > Humans </option> <option value="hydrobiology" > Hydrobiology </option> <option value="hydrogen" > Hydrogen </option> <option value="hydrology" > Hydrology </option> <option value="hygiene" > Hygiene </option> <option value="immuno" > Immuno </option> <option value="idr" > Infectious Disease Reports </option> <option value="informatics" > Informatics </option> <option value="information" > Information </option> <option value="infrastructures" > Infrastructures </option> <option value="inorganics" > Inorganics </option> <option value="insects" > Insects </option> <option value="instruments" > Instruments </option> <option value="iic" > Intelligent Infrastructure and Construction </option> <option value="ijerph" > International Journal of Environmental Research and Public Health (IJERPH) </option> <option value="ijfs" > International Journal of Financial Studies (IJFS) </option> <option value="ijms" > International Journal of Molecular Sciences (IJMS) </option> <option value="IJNS" > International Journal of Neonatal Screening (IJNS) </option> <option value="ijpb" > International Journal of Plant Biology (IJPB) </option> <option value="ijt" > International Journal of Topology </option> <option value="ijtm" > International Journal of Translational Medicine (IJTM) </option> <option value="ijtpp" > International Journal of Turbomachinery, Propulsion and Power (IJTPP) </option> <option value="ime" > International Medical Education (IME) </option> <option value="inventions" > Inventions </option> <option value="IoT" > IoT </option> <option value="ijgi" > ISPRS International Journal of Geo-Information (IJGI) </option> <option value="J" > J </option> <option value="jal" > Journal of Ageing and Longevity (JAL) </option> <option value="jcdd" > Journal of Cardiovascular Development and Disease (JCDD) </option> <option value="jcto" > Journal of Clinical & Translational Ophthalmology (JCTO) </option> <option value="jcm" > Journal of Clinical Medicine (JCM) </option> <option value="jcs" > Journal of Composites Science (J. Compos. Sci.) </option> <option value="jcp" > Journal of Cybersecurity and Privacy (JCP) </option> <option value="jdad" > Journal of Dementia and Alzheimer's Disease (JDAD) </option> <option value="jdb" > Journal of Developmental Biology (JDB) </option> <option value="jeta" > Journal of Experimental and Theoretical Analyses (JETA) </option> <option value="jfb" > Journal of Functional Biomaterials (JFB) </option> <option value="jfmk" > Journal of Functional Morphology and Kinesiology (JFMK) </option> <option value="jof" > Journal of Fungi (JoF) </option> <option value="jimaging" > Journal of Imaging (J. Imaging) </option> <option value="jintelligence" > Journal of Intelligence (J. Intell.) </option> <option value="jlpea" > Journal of Low Power Electronics and Applications (JLPEA) </option> <option value="jmmp" > Journal of Manufacturing and Materials Processing (JMMP) </option> <option value="jmse" > Journal of Marine Science and Engineering (JMSE) </option> <option value="jmahp" > Journal of Market Access & Health Policy (JMAHP) </option> <option value="jmp" > Journal of Molecular Pathology (JMP) </option> <option value="jnt" > Journal of Nanotheranostics (JNT) </option> <option value="jne" > Journal of Nuclear Engineering (JNE) </option> <option value="ohbm" > Journal of Otorhinolaryngology, Hearing and Balance Medicine (JOHBM) </option> <option value="jop" > Journal of Parks </option> <option value="jpm" > Journal of Personalized Medicine (JPM) </option> <option value="jpbi" > Journal of Pharmaceutical and BioTech Industry (JPBI) </option> <option value="jor" > Journal of Respiration (JoR) </option> <option value="jrfm" > Journal of Risk and Financial Management (JRFM) </option> <option value="jsan" > Journal of Sensor and Actuator Networks (JSAN) </option> <option value="joma" > Journal of the Oman Medical Association (JOMA) </option> <option value="jtaer" > Journal of Theoretical and Applied Electronic Commerce Research (JTAER) </option> <option value="jvd" > Journal of Vascular Diseases (JVD) </option> <option value="jox" > Journal of Xenobiotics (JoX) </option> <option value="jzbg" > Journal of Zoological and Botanical Gardens (JZBG) </option> <option value="journalmedia" > Journalism and Media </option> <option value="kidneydial" > Kidney and Dialysis </option> <option value="kinasesphosphatases" > Kinases and Phosphatases </option> <option value="knowledge" > Knowledge </option> <option value="labmed" > LabMed </option> <option value="laboratories" > Laboratories </option> <option value="land" > Land </option> <option value="languages" > Languages </option> <option value="laws" > Laws </option> <option value="life" > Life </option> <option value="limnolrev" > Limnological Review </option> <option value="lipidology" > Lipidology </option> <option value="liquids" > Liquids </option> <option value="literature" > Literature </option> <option value="livers" > Livers </option> <option value="logics" > Logics </option> <option value="logistics" > Logistics </option> <option value="lubricants" > Lubricants </option> <option value="lymphatics" > Lymphatics </option> <option value="make" > Machine Learning and Knowledge Extraction (MAKE) </option> <option value="machines" > Machines </option> <option value="macromol" > Macromol </option> <option value="magnetism" > Magnetism </option> <option value="magnetochemistry" > Magnetochemistry </option> <option value="marinedrugs" > Marine Drugs </option> <option value="materials" > Materials </option> <option value="materproc" > Materials Proceedings </option> <option value="mca" > Mathematical and Computational Applications (MCA) </option> <option value="mathematics" > Mathematics </option> <option value="medsci" > Medical Sciences </option> <option value="msf" > Medical Sciences Forum </option> <option value="medicina" > Medicina </option> <option value="medicines" > Medicines </option> <option value="membranes" > Membranes </option> <option value="merits" > Merits </option> <option value="metabolites" > Metabolites </option> <option value="metals" > Metals </option> <option value="meteorology" > Meteorology </option> <option value="methane" > Methane </option> <option value="mps" > Methods and Protocols (MPs) </option> <option value="metrics" > Metrics </option> <option value="metrology" > Metrology </option> <option value="micro" > Micro </option> <option value="microbiolres" > Microbiology Research </option> <option value="micromachines" > Micromachines </option> <option value="microorganisms" > Microorganisms </option> <option value="microplastics" > Microplastics </option> <option value="minerals" > Minerals </option> <option value="mining" > Mining </option> <option value="modelling" > Modelling </option> <option value="mmphys" > Modern Mathematical Physics </option> <option value="molbank" > Molbank </option> <option value="molecules" > Molecules </option> <option value="mti" > Multimodal Technologies and Interaction (MTI) </option> <option value="muscles" > Muscles </option> <option value="nanoenergyadv" > Nanoenergy Advances </option> <option value="nanomanufacturing" > Nanomanufacturing </option> <option value="nanomaterials" > Nanomaterials </option> <option value="ndt" > NDT </option> <option value="network" > Network </option> <option value="neuroglia" > Neuroglia </option> <option value="neurolint" > Neurology International </option> <option value="neurosci" > NeuroSci </option> <option value="nitrogen" > Nitrogen </option> <option value="ncrna" > Non-Coding RNA (ncRNA) </option> <option value="nursrep" > Nursing Reports </option> <option value="nutraceuticals" > Nutraceuticals </option> <option value="nutrients" > Nutrients </option> <option value="obesities" > Obesities </option> <option value="oceans" > Oceans </option> <option value="onco" > Onco </option> <option value="optics" > Optics </option> <option value="oral" > Oral </option> <option value="organics" > Organics </option> <option value="organoids" > Organoids </option> <option value="osteology" > Osteology </option> <option value="oxygen" > Oxygen </option> <option value="parasitologia" > Parasitologia </option> <option value="particles" > Particles </option> <option value="pathogens" > Pathogens </option> <option value="pathophysiology" > Pathophysiology </option> <option value="pediatrrep" > Pediatric Reports </option> <option value="pets" > Pets </option> <option value="pharmaceuticals" > Pharmaceuticals </option> <option value="pharmaceutics" > Pharmaceutics </option> <option value="pharmacoepidemiology" > Pharmacoepidemiology </option> <option value="pharmacy" > Pharmacy </option> <option value="philosophies" > Philosophies </option> <option value="photochem" > Photochem </option> <option value="photonics" > Photonics </option> <option value="phycology" > Phycology </option> <option value="physchem" > Physchem </option> <option value="psf" > Physical Sciences Forum </option> <option value="physics" > Physics </option> <option value="physiologia" > Physiologia </option> <option value="plants" > Plants </option> <option value="plasma" > Plasma </option> <option value="platforms" > Platforms </option> <option value="pollutants" > Pollutants </option> <option value="polymers" > Polymers </option> <option value="polysaccharides" > Polysaccharides </option> <option value="populations" > Populations </option> <option value="poultry" > Poultry </option> <option value="powders" > Powders </option> <option value="proceedings" > Proceedings </option> <option value="processes" > Processes </option> <option value="prosthesis" > Prosthesis </option> <option value="proteomes" > Proteomes </option> <option value="psychiatryint" > Psychiatry International </option> <option value="psychoactives" > Psychoactives </option> <option value="psycholint" > Psychology International </option> <option value="publications" > Publications </option> <option value="qubs" > Quantum Beam Science (QuBS) </option> <option value="quantumrep" > Quantum Reports </option> <option value="quaternary" > Quaternary </option> <option value="radiation" > Radiation </option> <option value="reactions" > Reactions </option> <option value="realestate" > Real Estate </option> <option value="receptors" > Receptors </option> <option value="recycling" > Recycling </option> <option value="rsee" > Regional Science and Environmental Economics (RSEE) </option> <option value="religions" > Religions </option> <option value="remotesensing" > Remote Sensing </option> <option value="reports" > Reports </option> <option value="reprodmed" > Reproductive Medicine (Reprod. Med.) </option> <option value="resources" > Resources </option> <option value="rheumato" selected='selected'> Rheumato </option> <option value="risks" > Risks </option> <option value="robotics" > Robotics </option> <option value="ruminants" > Ruminants </option> <option value="safety" > Safety </option> <option value="sci" > Sci </option> <option value="scipharm" > Scientia Pharmaceutica (Sci. Pharm.) </option> <option value="sclerosis" > Sclerosis </option> <option value="seeds" > Seeds </option> <option value="sensors" > Sensors </option> <option value="separations" > Separations </option> <option value="sexes" > Sexes </option> <option value="signals" > Signals </option> <option value="sinusitis" > Sinusitis </option> <option value="smartcities" > Smart Cities </option> <option value="socsci" > Social Sciences </option> <option value="siuj" > Société Internationale d’Urologie Journal (SIUJ) </option> <option value="societies" > Societies </option> <option value="software" > Software </option> <option value="soilsystems" > Soil Systems </option> <option value="solar" > Solar </option> <option value="solids" > Solids </option> <option value="spectroscj" > Spectroscopy Journal </option> <option value="sports" > Sports </option> <option value="standards" > Standards </option> <option value="stats" > Stats </option> <option value="stresses" > Stresses </option> <option value="surfaces" > Surfaces </option> <option value="surgeries" > Surgeries </option> <option value="std" > Surgical Techniques Development </option> <option value="sustainability" > Sustainability </option> <option value="suschem" > Sustainable Chemistry </option> <option value="symmetry" > Symmetry </option> <option value="synbio" > SynBio </option> <option value="systems" > Systems </option> <option value="targets" > Targets </option> <option value="taxonomy" > Taxonomy </option> <option value="technologies" > Technologies </option> <option value="telecom" > Telecom </option> <option value="textiles" > Textiles </option> <option value="thalassrep" > Thalassemia Reports </option> <option value="therapeutics" > Therapeutics </option> <option value="thermo" > Thermo </option> <option value="timespace" > Time and Space </option> <option value="tomography" > Tomography </option> <option value="tourismhosp" > Tourism and Hospitality </option> <option value="toxics" > Toxics </option> <option value="toxins" > Toxins </option> <option value="transplantology" > Transplantology </option> <option value="traumacare" > Trauma Care </option> <option value="higheredu" > Trends in Higher Education </option> <option value="tropicalmed" > Tropical Medicine and Infectious Disease (TropicalMed) </option> <option value="universe" > Universe </option> <option value="urbansci" > Urban Science </option> <option value="uro" > Uro </option> <option value="vaccines" > Vaccines </option> <option value="vehicles" > Vehicles </option> <option value="venereology" > Venereology </option> <option value="vetsci" > Veterinary Sciences </option> <option value="vibration" > Vibration </option> <option value="virtualworlds" > Virtual Worlds </option> <option value="viruses" > Viruses </option> <option value="vision" > Vision </option> <option value="waste" > Waste </option> <option value="water" > Water </option> <option value="wild" > Wild </option> <option value="wind" > Wind </option> <option value="women" > Women </option> <option value="world" > World </option> <option value="wevj" > World Electric Vehicle Journal (WEVJ) </option> <option value="youth" > Youth </option> <option value="zoonoticdis" > Zoonotic Diseases </option> </select> </div> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Article Type</div> </div> <select id="article_type" tabindex="4" name="article_type" class="chosen-select"> <option value="">All Article Types</option> <option value="research-article">Article</option> <option value="review-article">Review</option> <option value="rapid-communication">Communication</option> <option value="editorial">Editorial</option> <option value="abstract">Abstract</option> <option value="book-review">Book Review</option> <option value="brief-communication">Brief Communication</option> <option value="brief-report">Brief Report</option> <option value="case-report">Case Report</option> <option value="clinicopathological-challenge">Clinicopathological Challenge</option> <option value="article-commentary">Comment</option> <option value="commentary">Commentary</option> <option value="concept-paper">Concept Paper</option> <option value="conference-report">Conference Report</option> <option value="correction">Correction</option> <option value="creative">Creative</option> <option value="data-descriptor">Data Descriptor</option> <option value="discussion">Discussion</option> <option value="Entry">Entry</option> <option value="essay">Essay</option> <option value="expression-of-concern">Expression of Concern</option> <option value="extended-abstract">Extended Abstract</option> <option value="field-guide">Field Guide</option> <option value="guidelines">Guidelines</option> <option value="hypothesis">Hypothesis</option> <option value="interesting-image">Interesting Images</option> <option value="letter">Letter</option> <option value="books-received">New Book Received</option> <option value="obituary">Obituary</option> <option value="opinion">Opinion</option> <option value="perspective">Perspective</option> <option value="proceedings">Proceeding Paper</option> <option value="project-report">Project Report</option> <option value="protocol">Protocol</option> <option value="registered-report">Registered Report</option> <option value="reply">Reply</option> <option value="retraction">Retraction</option> <option value="note">Short Note</option> <option value="study-protocol">Study Protocol</option> <option value="systematic_review">Systematic Review</option> <option value="technical-note">Technical Note</option> <option value="tutorial">Tutorial</option> <option value="viewpoint">Viewpoint</option> </select> </div> <div class="large-1 medium-1 small-6 end columns small-push-6 medium-reset-order large-reset-order js-search-collapsed-button-container"> <div class="search-input-label"> </div> <input type="submit" id="search" value="Search" class="button button--dark button--full-width searchButton1 US_SearchButton" tabindex="12"> </div> <div class="large-1 medium-1 small-6 end columns large-text-left small-only-text-center small-pull-6 medium-reset-order large-reset-order js-search-collapsed-link-container"> <div class="search-input-label"> </div> <a class="main-search-clear search-container__link" href="#" onclick="openAdvanced(''); return false;">Advanced<span class="show-for-small-only"> Search</span></a> </div> </div> </div> <div class="search-container__advanced" style="margin-top: 0; padding-top: 0px; background-color: inherit; color: inherit;"> <div class="row"> <div class="large-2 medium-2 columns show-for-medium-up"> </div> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Section</div> </div> <select id="section" tabindex="5" name="section" class="chosen-select"> <option value=""></option> </select> </div> <div class="large-2 medium-2 small-6 columns "> <div class=""> <div class="search-input-label">Special Issue</div> </div> <select id="special_issue" tabindex="6" name="special_issue" class="chosen-select"> <option value=""></option> </select> </div> <div class="large-1 medium-1 small-6 end columns "> <div class="search-input-label">Volume</div> <input type="text" id="volume" tabindex="7" name="volume" placeholder="..." value="4" /> </div> <div class="large-1 medium-1 small-6 end columns "> <div class="search-input-label">Issue</div> <input type="text" id="issue" tabindex="8" name="issue" placeholder="..." value="3" /> </div> <div class="large-1 medium-1 small-6 end columns "> <div class="search-input-label">Number</div> <input type="text" id="number" tabindex="9" name="number" placeholder="..." value="" /> </div> <div class="large-1 medium-1 small-6 end columns "> <div class="search-input-label">Page</div> <input type="text" id="page" tabindex="10" name="page" placeholder="..." value="" /> </div> <div class="large-1 medium-1 small-6 columns small-push-6 medium-reset order large-reset-order medium-reset-order js-search-expanded-button-container"></div> <div class="large-1 medium-1 small-6 columns large-text-left small-only-text-center small-pull-6 medium-reset-order large-reset-order js-search-expanded-link-container"></div> </div> </div> </form> <form id="advanced-search" class="large-12 medium-12 columns"> <div class="search-container__advanced"> <div id="advanced-search-template" class="row advanced-search-row"> <div class="large-2 medium-2 small-12 columns show-for-medium-up"> </div> <div class="large-2 medium-2 small-3 columns connector-div"> <div class="search-input-label"><span class="show-for-medium-up">Logical Operator</span><span class="show-for-small">Operator</span></div> <select class="connector"> <option value="and">AND</option> <option value="or">OR</option> </select> </div> <div class="large-3 medium-3 small-6 columns search-text-div"> <div class="search-input-label">Search Text</div> <input type="text" class="search-text" placeholder="Search text"> </div> <div class="large-2 medium-2 small-6 large-offset-0 medium-offset-0 small-offset-3 columns search-field-div"> <div class="search-input-label">Search Type</div> <select class="search-field"> <option value="all">All fields</option> <option value="title">Title</option> <option value="abstract">Abstract</option> <option value="keywords">Keywords</option> <option value="authors">Authors</option> <option value="affiliations">Affiliations</option> <option value="doi">Doi</option> <option value="full_text">Full Text</option> <option value="references">References</option> </select> </div> <div class="large-1 medium-1 small-3 columns"> <div class="search-input-label"> </div> <div class="search-action-div"> <div class="search-plus"> <i class="material-icons">add_circle_outline</i> </div> </div> <div class="search-action-div"> <div class="search-minus"> <i class="material-icons">remove_circle_outline</i> </div> </div> </div> <div class="large-1 medium-1 small-6 large-offset-0 medium-offset-0 small-offset-3 end columns"> <div class="search-input-label"> </div> <input class="advanced-search-button button button--dark search-submit" type="submit" value="Search"> </div> <div class="large-1 medium-1 small-6 end columns show-for-medium-up"></div> </div> </div> </form> </div> <div class="header-divider"> </div> <div class="breadcrumb row full-row"> <div class="breadcrumb__element"> <a href="/about/journals">Journals</a> </div> <div class="breadcrumb__element"> <a href="/journal/rheumato">Rheumato</a> </div> <div class="breadcrumb__element"> <a href="/2674-0621/4">Volume 4</a> </div> <div class="breadcrumb__element"> <a href="/2674-0621/4/3">Issue 3</a> </div> <div class="breadcrumb__element"> <a href="#">10.3390/rheumato4030012</a> </div> </div> </header> <div id="main-content" class=""> <div class="row full-width row-fixed-left-column"> <div id="left-column" class="content__column large-3 medium-3 small-12 columns"> <div class="content__container"> <a href="/journal/rheumato"> <img src="https://pub.mdpi-res.com/img/journals/rheumato-logo.png?fc246099e5001501" alt="rheumato-logo" title="Rheumato" style="max-height: 60px; margin: 0 0 0 0;"> </a> <div class="generic-item no-border"> <a class="button button--color button--full-width js-journal-active-only-link js-journal-active-only-submit-link UC_ArticleSubmitButton" href="https://susy.mdpi.com/user/manuscripts/upload?form%5Bjournal_id%5D%3D506" data-disabledmessage="creating new submissions is not possible."> Submit to this Journal </a> <a class="button button--color button--full-width js-journal-active-only-link UC_ArticleReviewButton" href="https://susy.mdpi.com/volunteer/journals/review" data-disabledmessage="volunteering as journal reviewer is not possible."> Review for this Journal </a> <a class="button button--color-inversed button--color-journal button--full-width js-journal-active-only-link UC_ArticleEditIssueButton" href="/journalproposal/sendproposalspecialissue/rheumato" data-path="/2674-0621/4/3/12" data-disabledmessage="proposing new special issue is not possible."> Propose a Special Issue </a> </div> <div class="generic-item link-article-menu show-for-small"> <a href="#" class="link-article-menu show-for-small"> <span class="closed">►</span> <span class="open" style="display: none;">▼</span> Article Menu </a> </div> <div class="hide-small-down-initially UI_ArticleMenu"> <div class="generic-item"> <h2>Article Menu</h2> </div> <ul class="accordion accordion__menu" data-accordion data-options="multi_expand:true;toggleable: true"> <li class="accordion-navigation"> <a href="#academic_editors" class="accordion__title">Academic Editor</a> <div id="academic_editors" class="content active"> <div class="academic-editor-container " title="Department of Medicine, Indiana University Ball, Memorial Hospital, Muncie, IN, USA"> <div class="sciprofiles-link" style="display: inline-block"><a class="sciprofiles-link__link" href="https://sciprofiles.com/profile/1639338?utm_source=mdpi.com&utm_medium=website&utm_campaign=avatar_name" target="_blank" rel="noopener noreferrer"><img class="sciprofiles-link__image" src="/profiles/1639338/thumb/Bruce_Rothschild.png" style="width: auto; height: 16px; border-radius: 50%;"><span class="sciprofiles-link__name">Bruce M. Rothschild</span></a></div> </div> </div> </li> <li class="accordion-direct-link"> <a href="/2674-0621/4/3/12/scifeed_display" data-reveal-id="scifeed-modal" data-reveal-ajax="true">Subscribe SciFeed</a> </li> <li class="accordion-direct-link js-article-similarity-container" style="display: none"> <a href="#" class="js-similarity-related-articles">Recommended Articles</a> </li> <li class="accordion-navigation"> <a href="#related" class="accordion__title">Related Info Link</a> <div id="related" class="content UI_ArticleMenu_RelatedLinks"> <ul> <li class="li-link"> <a href="https://scholar.google.com/scholar?q=Presentation%2C%20Characteristics%20and%20Features%20of%20Lymphoma%20in%20a%20Retrospective%20Case%20Series%20of%20Patients%20with%20Sjogren%E2%80%99s%20Disease" target="_blank" rel="noopener noreferrer">Google Scholar</a> </li> </ul> </div> </li> <li class="accordion-navigation"> <a href="#authors" class="accordion__title">More by Authors Links</a> <div id="authors" class="content UI_ArticleMenu_AuthorsLinks"> <ul class="side-menu-ul"> <li> <a class="expand" onclick='$(this).closest("li").next("div").toggle(); return false;'>on DOAJ</a> </li> <div id="AuthorDOAJExpand" style="display:none;"> <ul class="submenu"> <li class="li-link"> <a href='http://doaj.org/search/articles?source=%7B%22query%22%3A%7B%22query_string%22%3A%7B%22query%22%3A%22%5C%22Jennifer%20Behbodikhah%5C%22%22%2C%22default_operator%22%3A%22AND%22%2C%22default_field%22%3A%22bibjson.author.name%22%7D%7D%7D' target="_blank" rel="noopener noreferrer">Behbodikhah, J.</a> <li> </li> <li class="li-link"> <a href='http://doaj.org/search/articles?source=%7B%22query%22%3A%7B%22query_string%22%3A%7B%22query%22%3A%22%5C%22Lisa%20Balistreri%5C%22%22%2C%22default_operator%22%3A%22AND%22%2C%22default_field%22%3A%22bibjson.author.name%22%7D%7D%7D' target="_blank" rel="noopener noreferrer">Balistreri, L.</a> <li> </li> <li class="li-link"> <a href='http://doaj.org/search/articles?source=%7B%22query%22%3A%7B%22query_string%22%3A%7B%22query%22%3A%22%5C%22Steven%20E.%20Carsons%5C%22%22%2C%22default_operator%22%3A%22AND%22%2C%22default_field%22%3A%22bibjson.author.name%22%7D%7D%7D' target="_blank" rel="noopener noreferrer">Carsons, S. E.</a> <li> </li> </ul> </div> <li> <a class="expand" onclick='$(this).closest("li").next("div").toggle(); return false;'>on Google Scholar</a> </li> <div id="AuthorGoogleExpand" style="display:none;"> <ul class="submenu"> <li class="li-link"> <a href="https://scholar.google.com/scholar?q=Jennifer%20Behbodikhah" target="_blank" rel="noopener noreferrer">Behbodikhah, J.</a> <li> </li> <li class="li-link"> <a href="https://scholar.google.com/scholar?q=Lisa%20Balistreri" target="_blank" rel="noopener noreferrer">Balistreri, L.</a> <li> </li> <li class="li-link"> <a href="https://scholar.google.com/scholar?q=Steven%20E.%20Carsons" target="_blank" rel="noopener noreferrer">Carsons, S. E.</a> <li> </li> </ul> </div> <li> <a class="expand" onclick='$(this).closest("li").next("div").toggle(); return false;'>on PubMed</a> </li> <div id="AuthorPubMedExpand" style="display:none;"> <ul class="submenu"> <li class="li-link"> <a href="http://www.pubmed.gov/?cmd=Search&term=Jennifer%20Behbodikhah" target="_blank" rel="noopener noreferrer">Behbodikhah, J.</a> <li> </li> <li class="li-link"> <a href="http://www.pubmed.gov/?cmd=Search&term=Lisa%20Balistreri" target="_blank" rel="noopener noreferrer">Balistreri, L.</a> <li> </li> <li class="li-link"> <a href="http://www.pubmed.gov/?cmd=Search&term=Steven%20E.%20Carsons" target="_blank" rel="noopener noreferrer">Carsons, S. E.</a> <li> </li> </ul> </div> </ul> </div> </li> </ul> <span style="display:none" id="scifeed_hidden_flag"></span> <span style="display:none" id="scifeed_subscribe_url">/ajax/scifeed/subscribe</span> </div> </div> <div class="content__container responsive-moving-container large medium active hidden" data-id="article-counters"> <div id="counts-wrapper" class="row generic-item no-border" data-equalizer> <div id="js-counts-wrapper__views" class="small-12 hide columns count-div-container"> <a href="#metrics" > <div class="count-div" data-equalizer-watch> <span class="name">Article Views</span> <span class="count view-number"></span> </div> </a> </div> <div id="js-counts-wrapper__citations" class="small-12 columns hide count-div-container"> <a href="#metrics" > <div class="count-div" data-equalizer-watch> <span class="name">Citations</span> <span class="count citations-number Var_ArticleMaxCitations">-</span> </div> </a> </div> </div> </div> <div class="content__container"> <div class="hide-small-down-initially"> <ul class="accordion accordion__menu" data-accordion data-options="multi_expand:true;toggleable: true"> <li class="accordion-navigation"> <a href="#table_of_contents" class="accordion__title">Table of Contents</a> <div id="table_of_contents" class="content active"> <div class="menu-caption" id="html-quick-links-title"></div> </div> </li> </ul> </div> </div>  <div id="pbgrd-sky"></div> <script src="https://cdn.pbgrd.com/core-mdpi.js"></script> <style>.content__container { min-width: 300px; }</style>  </div> <div id="middle-column" class="content__column large-9 medium-9 small-12 columns end middle-bordered"> <div class="middle-column__help"> <div class="middle-column__help__fixed show-for-medium-up"> <span id="js-altmetrics-donut" href="#" target="_blank" rel="noopener noreferrer" style="display: none;"> <span data-badge-type='donut' class='altmetric-embed' data-doi='10.3390/rheumato4030012'></span> <span>Altmetric</span> </span> <a href="#" class="UA_ShareButton" data-reveal-id="main-share-modal" title="Share"> <i class="material-icons">share</i> <span>Share</span> </a> <a href="#" data-reveal-id="main-help-modal" title="Help"> <i class="material-icons">announcement</i> <span>Help</span> </a> <a href="javascript:void(0);" data-reveal-id="cite-modal" data-counterslink = "https://www.mdpi.com/2674-0621/4/3/12/cite" > <i class="material-icons">format_quote</i> <span>Cite</span> </a> <a href="https://sciprofiles.com/discussion-groups/public/10.3390/rheumato4030012?utm_source=mpdi.com&utm_medium=publication&utm_campaign=discuss_in_sciprofiles" target="_blank" rel="noopener noreferrer" title="Discuss in Sciprofiles"> <i class="material-icons">question_answer</i> <span>Discuss in SciProfiles</span> </a> <a href="#" class="" data-hypothesis-trigger-endorses-tab title="Endorse"> <i data-hypothesis-endorse-trigger class="material-icons" >thumb_up</i> <div data-hypothesis-endorsement-count data-hypothesis-trigger-endorses-tab class="hypothesis-count-container"> ... </div> <span>Endorse</span> </a> <a href="#" data-hypothesis-trigger class="js-hypothesis-open UI_ArticleAnnotationsButton" title="Comment"> <i class="material-icons">textsms</i> <div data-hypothesis-annotation-count class="hypothesis-count-container"> ... </div> <span>Comment</span> </a> </div> <div id="main-help-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog"> <div class="row"> <div class="small-12 columns"> <h2 style="margin: 0;">Need Help?</h2> </div> <div class="small-6 columns"> <h3>Support</h3> <p> Find support for a specific problem in the support section of our website. </p> <a target="_blank" href="/about/contactform" class="button button--color button--full-width"> Get Support </a> </div> <div class="small-6 columns"> <h3>Feedback</h3> <p> Please let us know what you think of our products and services. </p> <a target="_blank" href="/feedback/send" class="button button--color button--full-width"> Give Feedback </a> </div> <div class="small-6 columns end"> <h3>Information</h3> <p> Visit our dedicated information section to learn more about MDPI. </p> <a target="_blank" href="/authors" class="button button--color button--full-width"> Get Information </a> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> </div> <div class="middle-column__main "> <div class="page-highlight"> <style type="text/css"> img.review-status { width: 30px; } </style> <div id="jmolModal" class="reveal-modal" data-reveal aria-labelledby="Captcha" aria-hidden="true" role="dialog"> <h2>JSmol Viewer</h2> <div class="row"> <div class="small-12 columns text-center"> <iframe style="width: 520px; height: 520px;" frameborder="0" id="jsmol-content"></iframe> <div class="content"></div> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> <div itemscope itemtype="http://schema.org/ScholarlyArticle" id="abstract" class="abstract_div"> <div class="js-check-update-container"></div> <div class="html-content__container content__container content__container__combined-for-large__first" style="overflow: auto; position: inherit;"> <div class='html-profile-nav'> <div class='top-bar'> <div class='nav-sidebar-btn show-for-large-up' data-status='opened' > <i class='material-icons'>first_page</i> </div> <a id="js-button-download" class="button button--color-inversed" style="display: none;" href="/2674-0621/4/3/12/pdf?version=1726126250" data-name="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease" data-journal="rheumato"> <i class="material-icons custom-download"></i> Download PDF </a> <div class='nav-btn'> <i class='material-icons'>settings</i> </div> <a href="/2674-0621/4/3/12/reprints" id="js-button-reprints" class="button button--color-inversed"> Order Article Reprints </a> </div> <div class='html-article-menu'> <div class='html-first-step row'> <div class='html-font-family large-6 medium-6 small-12 columns'> <div class='row'> <div class='html-font-label large-4 medium-4 small-12 columns'> Font Type: </div> <div class='large-8 medium-8 small-12 columns'> <span class="html-article-menu-option"><i style='font-family:Arial, Arial, Helvetica, sans-serif;' data-fontfamily='Arial, Arial, Helvetica, sans-serif'>Arial</i></span> <span class="html-article-menu-option"><i style='font-family:Georgia1, Georgia, serif;' data-fontfamily='Georgia1, Georgia, serif'>Georgia</i></span> <span class="html-article-menu-option"><i style='font-family:Verdana, Verdana, Geneva, sans-serif;' data-fontfamily='Verdana, Verdana, Geneva, sans-serif' >Verdana</i></span> </div> </div> </div> <div class='html-font-resize large-6 medium-6 small-12 columns'> <div class='row'> <div class='html-font-label large-4 medium-4 small-12 columns'>Font Size:</div> <div class='large-8 medium-8 small-12 columns'> <span class="html-article-menu-option a1" data-percent="100">Aa</span> <span class="html-article-menu-option a2" data-percent="120">Aa</span> <span class="html-article-menu-option a3" data-percent="160">Aa</span> </div> </div> </div> </div> <div class='row'> <div class='html-line-space large-6 medium-6 small-12 columns'> <div class='row'> <div class='html-font-label large-4 medium-4 small-12 columns' >Line Spacing:</div> <div class='large-8 medium-8 small-12 columns'> <span class="html-article-menu-option a1" data-line-height="1.5em"> <i class="fa"></i> </span> <span class="html-article-menu-option a2" data-line-height="1.8em"> <i class="fa"></i> </span> <span class="html-article-menu-option a3" data-line-height="2.1em"> <i class="fa"></i> </span> </div> </div> </div> <div class='html-column-width large-6 medium-6 small-12 columns'> <div class='row'> <div class='html-font-label large-4 medium-4 small-12 columns' >Column Width:</div> <div class='large-8 medium-8 small-12 columns'> <span class="html-article-menu-option a1" data-column-width="20%"> <i class="fa"></i> </span> <span class="html-article-menu-option a2" data-column-width="10%"> <i class="fa"></i> </span> <span class="html-article-menu-option a3" data-column-width="0%"> <i class="fa"></i> </span> </div> </div> </div> </div> <div class='row'> <div class='html-font-bg large-6 medium-6 small-12 columns end'> <div class='row'> <div class='html-font-label large-4 medium-4 small-12 columns'>Background:</div> <div class='large-8 medium-8 small-12 columns'> <div class="html-article-menu-option html-nav-bg html-nav-bright" data-bg="bright"> <i class="fa fa-file-text"></i> </div> <div class="html-article-menu-option html-nav-bg html-nav-dark" data-bg="dark"> <i class="fa fa-file-text-o"></i> </div> <div class="html-article-menu-option html-nav-bg html-nav-creme" data-bg="creme"> <i class="fa fa-file-text"></i> </div> </div> </div> </div> </div> </div> </div> <article ><div class='html-article-content'> <span itemprop="publisher" content="Multidisciplinary Digital Publishing Institute"></span><span itemprop="url" content="https://www.mdpi.com/2674-0621/4/3/12"></span> <div class="article-icons"><span class="label openaccess" data-dropdown="drop-article-label-openaccess" aria-expanded="false">Open Access</span><span class="label articletype">Article</span></div> <h1 class="title hypothesis_container" itemprop="name"> Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease </h1> <div class="art-authors hypothesis_container"> by <span class="inlineblock "><div class='profile-card-drop' data-dropdown='profile-card-drop13090817' data-options='is_hover:true, hover_timeout:5000'> Jennifer Behbodikhah</div><div id="profile-card-drop13090817" data-dropdown-content class="f-dropdown content profile-card-content" aria-hidden="true" tabindex="-1"><div class="profile-card__title"><div class="sciprofiles-link" style="display: inline-block"><div class="sciprofiles-link__link"><img class="sciprofiles-link__image" src="/bundles/mdpisciprofileslink/img/unknown-user.png" style="width: auto; height: 16px; border-radius: 50%;"><span class="sciprofiles-link__name">Jennifer Behbodikhah</span></div></div></div><div class="profile-card__buttons" style="margin-bottom: 10px;"><a href="https://sciprofiles.com/profile/3709083?utm_source=mdpi.com&utm_medium=website&utm_campaign=avatar_name" class="button button--color-inversed" target="_blank"> SciProfiles </a><a href="https://scilit.net/scholars?q=Jennifer%20Behbodikhah" class="button button--color-inversed" target="_blank"> Scilit </a><a href="https://www.preprints.org/search?search1=Jennifer%20Behbodikhah&field1=authors" class="button button--color-inversed" target="_blank"> Preprints.org </a><a href="https://scholar.google.com/scholar?q=Jennifer%20Behbodikhah" class="button button--color-inversed" target="_blank" rels="noopener noreferrer"> Google Scholar </a></div></div><sup> *</sup><span style="display: inline; margin-left: 5px;"></span><a class="toEncode emailCaptcha visibility-hidden" data-author-id="13090817" href="/cdn-cgi/l/email-protection#85aae6ebe1a8e6e2ecaae9aae0e8e4ece9a8f5f7eaf1e0e6f1eceaeba6b5b5b5e3b3e4b5b1b5b1b5b6b5e6b5e3b4bdb1b1b5bdb5e3b5b7b5bdb5b0b5e0b5b6b5b4b5b7b5e7b5b7b7e4b5b1b4b6b4e3b5b3b5e7b5b1b5e1b5b0b5b1b5e3b1b1b5b0b4bdb5e1"><sup><i class="fa fa-envelope-o"></i></sup></a>, </span><span class="inlineblock "><div class='profile-card-drop' data-dropdown='profile-card-drop13090818' data-options='is_hover:true, hover_timeout:5000'> Lisa Balistreri</div><div id="profile-card-drop13090818" data-dropdown-content class="f-dropdown content profile-card-content" aria-hidden="true" tabindex="-1"><div class="profile-card__title"><div class="sciprofiles-link" style="display: inline-block"><div class="sciprofiles-link__link"><img class="sciprofiles-link__image" src="/bundles/mdpisciprofileslink/img/unknown-user.png" style="width: auto; height: 16px; border-radius: 50%;"><span class="sciprofiles-link__name">Lisa Balistreri</span></div></div></div><div class="profile-card__buttons" style="margin-bottom: 10px;"><a href="https://sciprofiles.com/profile/3709231?utm_source=mdpi.com&utm_medium=website&utm_campaign=avatar_name" class="button button--color-inversed" target="_blank"> SciProfiles </a><a href="https://scilit.net/scholars?q=Lisa%20Balistreri" class="button button--color-inversed" target="_blank"> Scilit </a><a href="https://www.preprints.org/search?search1=Lisa%20Balistreri&field1=authors" class="button button--color-inversed" target="_blank"> Preprints.org </a><a href="https://scholar.google.com/scholar?q=Lisa%20Balistreri" class="button button--color-inversed" target="_blank" rels="noopener noreferrer"> Google Scholar </a></div></div><sup> *</sup><span style="display: inline; margin-left: 5px;"></span><a class="toEncode emailCaptcha visibility-hidden" data-author-id="13090818" href="/cdn-cgi/l/email-protection#f3dc909d97de90949adc9fdc969e929a9fde83819c879690879a9c9dd0c3c3c3c2c590c396c397c3c3c3c6c295c2cbc296c3cac296c3c6c190c391c3c2c397c3c6c3c3c7c1c395c3c0c3c2"><sup><i class="fa fa-envelope-o"></i></sup></a><a href="https://orcid.org/0009-0008-4070-6557" target="_blank" rel="noopener noreferrer"><img src="https://pub.mdpi-res.com/img/design/orcid.png?0465bc3812adeb52?1733310352" title="ORCID" style="position: relative; width: 13px; margin-left: 3px; max-width: 13px !important; height: auto; top: -5px;"></a> and </span><span class="inlineblock "><div class='profile-card-drop' data-dropdown='profile-card-drop13090819' data-options='is_hover:true, hover_timeout:5000'> Steven E. Carsons</div><div id="profile-card-drop13090819" data-dropdown-content class="f-dropdown content profile-card-content" aria-hidden="true" tabindex="-1"><div class="profile-card__title"><div class="sciprofiles-link" style="display: inline-block"><div class="sciprofiles-link__link"><img class="sciprofiles-link__image" src="/profiles/2028299/thumb/Steven_E._Carsons.png" style="width: auto; height: 16px; border-radius: 50%;"><span class="sciprofiles-link__name">Steven E. Carsons</span></div></div></div><div class="profile-card__buttons" style="margin-bottom: 10px;"><a href="https://sciprofiles.com/profile/2028299?utm_source=mdpi.com&utm_medium=website&utm_campaign=avatar_name" class="button button--color-inversed" target="_blank"> SciProfiles </a><a href="https://scilit.net/scholars?q=Steven%20E.%20Carsons" class="button button--color-inversed" target="_blank"> Scilit </a><a href="https://www.preprints.org/search?search1=Steven%20E.%20Carsons&field1=authors" class="button button--color-inversed" target="_blank"> Preprints.org </a><a href="https://scholar.google.com/scholar?q=Steven%20E.%20Carsons" class="button button--color-inversed" target="_blank" rels="noopener noreferrer"> Google Scholar </a></div></div><sup> *</sup><span style="display: inline; margin-left: 5px;"></span><a class="toEncode emailCaptcha visibility-hidden" data-author-id="13090819" href="/cdn-cgi/l/email-protection#f8d79b969cd59b9f91d794d79d95999194d5888a978c9d9b8c919796dbc8c8c8cfcfcbc9cec8cdc9cec99ccd9cc9c8c9cac8c9c8c8c99bc99cc8c8cbcbc99cc899c8cec99ec9cac99cc9ccc99bc99cc9cecd9cc99bc8c9c9cc"><sup><i class="fa fa-envelope-o"></i></sup></a></span> </div> <div class="nrm"></div> <span style="display:block; height:6px;"></span> <div></div> <div style="margin: 5px 0 15px 0;" class="hypothesis_container"> <div class="art-affiliations"> <div class="affiliation "> <div class="affiliation-name ">Division of Rheumatology, Allergy and Immunology, Department of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA</div> </div> <div class="affiliation"> <div class="affiliation-item"><sup>*</sup></div> <div class="affiliation-name ">Authors to whom correspondence should be addressed. </div> </div> </div> </div> <div class="bib-identity" style="margin-bottom: 10px;"> <em>Rheumato</em> <b>2024</b>, <em>4</em>(3), 153-162; <a href="https://doi.org/10.3390/rheumato4030012">https://doi.org/10.3390/rheumato4030012</a> </div> <div class="pubhistory" style="font-weight: bold; padding-bottom: 10px;"> <span style="display: inline-block">Submission received: 19 July 2024</span> / <span style="display: inline-block">Revised: 15 August 2024</span> / <span style="display: inline-block">Accepted: 28 August 2024</span> / <span style="display: inline-block">Published: 30 August 2024</span> </div> <div class="highlight-box1"> <div class="download"> <a class="button button--color-inversed button--drop-down" data-dropdown="drop-download-1467592" aria-controls="drop-supplementary-1467592" aria-expanded="false"> Download <i class="material-icons">keyboard_arrow_down</i> </a> <div id="drop-download-1467592" class="f-dropdown label__btn__dropdown label__btn__dropdown--button" data-dropdown-content aria-hidden="true" tabindex="-1"> <a class="UD_ArticlePDF" href="/2674-0621/4/3/12/pdf?version=1726126250" data-name="Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease" data-journal="rheumato">Download PDF</a> <br/> <a id="js-pdf-with-cover-access-captcha" href="#" data-target="/2674-0621/4/3/12/pdf-with-cover" class="accessCaptcha">Download PDF with Cover</a> <br/> <a id="js-xml-access-captcha" href="#" data-target="/2674-0621/4/3/12/xml" class="accessCaptcha">Download XML</a> <br/> <a href="/2674-0621/4/3/12/epub" id="epub_link">Download Epub</a> <br/> </div> <a class="button button--color-inversed" href="/2674-0621/4/3/12/notes">Versions Notes</a> </div> </div> <div class="responsive-moving-container small hidden" data-id="article-counters" style="margin-top: 15px;"></div> <div class="html-dynamic"> <section> <div class="art-abstract art-abstract-new in-tab hypothesis_container"> <p> <div><section class="html-abstract" id="html-abstract"> <h2 id="html-abstract-title">Abstract</h2><b>:</b> <div class="html-p">Sjogren’s Disease (SjD) is associated with an increased risk of lymphoma. We investigated the prevalence of lymphoma in a retrospective case series of patients with SjD and reported on the clinical presentation, treatment, response, and outcome. A retrospective review of 132 patients diagnosed with Sjogren’s Disease was conducted at our institution from June 2000 to November 2023, and 10 cases of malignant lymphoma were identified. Clinical and biological markers known to be predictors of lymphoma, as well as lymphoma characteristics, were examined. The most common predictive lab findings were hypergammaglobulinemia, the rheumatoid factor, and lymphopenia. Persistent parotid gland enlargement was also found in greater than 50% of patients. The majority of patients were Caucasian females, and the average time between the diagnosis of SjD and lymphoma was 14.3 years. The median age at lymphoma diagnosis was 59.5 years, with 9 out of 10 lymphomas identified as non-Hodgkin lymphoma, the majority of cases being mucosa-associated lymphoid tissue (MALT) lymphoma. We identified similarities in our series, such as laboratory markers and clinical symptoms, to those previously identified as possible predictors of lymphoma development. These factors may be useful in determining the risk of malignancy development and justify the need for long-term monitoring, as well as provider education and awareness.</div> </section> <div id="html-keywords"> <div class="html-gwd-group"><div id="html-keywords-title">Keywords: </div><a href="/search?q=Sjogren%E2%80%99s+disease+%28SjD%29">Sjogren’s disease (SjD)</a>; <a href="/search?q=lymphoma">lymphoma</a>; <a href="/search?q=parotid+gland">parotid gland</a></div> <div> </div> </div> </div> </p> </div> </section> </div> <div class="hypothesis_container"> <ul class="menu html-nav" data-prev-node="#html-quick-links-title"> </ul> <div class="html-body"> <section id='sec1-rheumato-04-00012' type='intro'><h2 data-nested='1'> 1. Introduction</h2><div class='html-p'>Sjogren’s Disease (SjD) is a chronic autoimmune disease defined by the lymphocytic infiltration of the exocrine glands, leading to their destruction and ultimately presenting predominantly with dry eyes and dry mouth [<a href="#B1-rheumato-04-00012" class="html-bibr">1</a>]. SjD may develop independently or in conjunction with another autoimmune condition, such as systemic lupus erythematosus, rheumatoid arthritis, or scleroderma. There is a well-known relationship between SjD and an increased risk of lymphoma, with previous reports finding the incidence of non-Hodgkin lymphoma (NHL) highest in SjD than all other autoimmune diseases [<a href="#B2-rheumato-04-00012" class="html-bibr">2</a>,<a href="#B3-rheumato-04-00012" class="html-bibr">3</a>]. The risk of lymphoma has been thought to be 4–16-fold higher in these patients than in the general population [<a href="#B3-rheumato-04-00012" class="html-bibr">3</a>,<a href="#B4-rheumato-04-00012" class="html-bibr">4</a>,<a href="#B5-rheumato-04-00012" class="html-bibr">5</a>,<a href="#B6-rheumato-04-00012" class="html-bibr">6</a>]. It has been hypothesized that the chronic inflammatory pathway seen in Sjogren’s Disease triggers B cell activation, potentially leading to the increased production of B lymphocytes and the eventual development of malignancy [<a href="#B7-rheumato-04-00012" class="html-bibr">7</a>].</div><div class='html-p'>Indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type has been recognized by several studies as the most common lymphoma subtype in SjD [<a href="#B8-rheumato-04-00012" class="html-bibr">8</a>]. The development of NHL may occur in 5–7% of SjD patients, usually within 10 years of diagnosis [<a href="#B9-rheumato-04-00012" class="html-bibr">9</a>,<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>]. However, there is variability from the diagnosis of SjD to the diagnosis of lymphoma, with some lymphomas diagnosed at the onset of SjD symptoms, while others have been reported as late as 36 years after disease onset [<a href="#B9-rheumato-04-00012" class="html-bibr">9</a>]. Some studies have shown that lymphoma may be one of the main causes of death in SjD [<a href="#B11-rheumato-04-00012" class="html-bibr">11</a>]. Reported mortality rates from lymphomas vary among different SjD patient groups, with the highest being in the 23–33% range [<a href="#B9-rheumato-04-00012" class="html-bibr">9</a>,<a href="#B12-rheumato-04-00012" class="html-bibr">12</a>]. Since malignant lymphoma is the main complication with a considerable impact on survival, it is important to identify the characteristics of SjD patients with lymphoma to help aid in early diagnosis and intervention. In this study, we investigate the prevalence of lymphoma in a series of patients with SjD and report on the clinical and laboratory presentation, response to treatment, and outcomes.</div></section><section id='sec2-rheumato-04-00012' type=''><h2 data-nested='1'> 2. Materials and Methods</h2><div class='html-p'>A medical records review of 132 patients diagnosed with primary Sjogren’s Disease was performed at our institution from the time period of June 2000 to November 2023, with 10 cases of malignant lymphoma identified. Data recorded on each patient includes sex, ethnicity, age at SjD diagnosis, the presence of anti-Ro (Sjogren’s Syndrome A, SSA) and anti-La (Sjogren’s Syndrome B, SSB), extraglandular manifestations, age at lymphoma diagnosis, the interval between the diagnosis of SjD and lymphoma, site of presentation, clinical staging, the lymphoma subtype, and final outcome (remission, relapse, progression of disease, and death). The lymphoma subtype was classified according to the 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms [<a href="#B13-rheumato-04-00012" class="html-bibr">13</a>].</div><div class='html-p'>We also recorded the clinical and serological features associated with lymphoma risk. The clinical predictors included persistent swelling of the parotid glands, peripheral neuropathy, splenomegaly, and palpable purpura. Lab abnormalities thought to be predictors of lymphoma include the presence of lymphopenia, defined as an absolute lymphocyte count < 1000/mm<sup>3</sup>, hypergammaglobulinemia, circulating monoclonal proteins in serum or urine, cryoglobulinemia, hypocomplementemia (C4) and the presence of a rheumatoid factor (RF), anti-nuclear antibody (ANA), SSA, or SSB.</div></section><section id='sec3-rheumato-04-00012' type='results'><h2 data-nested='1'> 3. Results</h2><div class='html-p'>In our series, 10 out of 132 patients (7.6%) developed lymphoma. The clinical and epidemiological features are displayed in <a href="#rheumato-04-00012-t001" class="html-table">Table 1</a>. The demographics of the lymphoma patients included 9 females and 1 male. The ethnicity breakdown is as follows: 6 Caucasians, 2 African Americans, 1 Asian/Indian, and 1 Hispanic patient. The mean age at diagnosis of Sjogren’s Disease was 44.9 years ± 10.2 with a range of 32–67. The mean age at lymphoma diagnosis was 58.5 years ± 12.6 with a range of 36–74, while the mean interval between SjD diagnosis and the development of lymphoma was 14.3 years ± 7.9 with a range of 1–25.</div><div class='html-p'>At the time of SjD diagnosis, 90% of our series had a positive SSA antibody, 50% had SSB, and one patient was seronegative. In total, 50% of our series was positive for both SSA and SSB antibodies. Prior to the development of lymphoma, 50% of our patients had parotid enlargement, 1 patient had parotitis, and 1 patient had parotid abscess. All of our patients demonstrated at least one extraglandular manifestation (EGM) of SjD ranging from 1 to 4 EGM with a mean of 2.1 EGM. In total, 4 patients had inflammatory polyarthritis, 4 had bronchiectasis, 3 had peripheral neuropathy, 2 had renal tubular acidosis (RTA) with nephrocalcinosis, and 1 had tubulointerstitial nephritis.</div><div class='html-p'>Based on the 2016 WHO classification, 9 out of the 10 lymphomas were of the non-Hodgkin subtype, all of which were of B-cell origin. A review of the pathology reports revealed 5 cases of the extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) types, 1 nodal marginal zone (MZL) type, 3 cases of diffuse large B cell lymphoma (DLBCL), and 1 patient with Hodgkin lymphoma at nodular sclerosis subtype stage IVB. Within our series, patients with MALT lymphoma were diagnosed at an earlier age as opposed to patients with non-MALT lymphoma. The average age of MALT lymphoma was 50.8 years ± 11.37, while the average age of non-MALT lymphoma diagnosis was 67.8 years ± 7.6 (<span class='html-italic'>p</span> = 0.03).</div><div class='html-p'>The clinical presentation of each lymphoma can be seen in <a href="#rheumato-04-00012-t001" class="html-table">Table 1</a>. These include the asymmetrical enlargement of the parotid or lacrimal glands, an intraglandular palpable mass followed by diffuse lymphadenopathy, monoclonal gammopathy, peripheral lymph node enlargement, and B-symptoms (fever, night sweats, and weight loss). The primary site of malignancy varied amongst patients. Overall, 1 patient had an incidental lung mass/nodule on chest computed tomography (CT), 2 patients had a left upper quadrant mass, 4 had glandular manifestations, and 4 patients had lymphadenopathy. Of the patients with glandular manifestations, 1 had a conjunctival mass and ocular inflammation, while 3 patients had parotid enlargement and/or a palpable mass. The location of lymphadenopathy varied and included the following sites: cervical, supraclavicular, mediastinal, axillary and inguinal. In total, five patients had B-symptoms (fever, night sweats, and weight loss). Additionally, staging at the time of lymphoma diagnosis disclosed the fact that the disease was limited to the primary site in 8 cases, while in 2 cases, the disease had already spread (stages III and IV).</div><div class='html-p'>Previously identified clinical and lab factors associated with the risk of lymphoma are summarized in <a href="#rheumato-04-00012-t002" class="html-table">Table 2</a>. The most prevalent clinical feature in our series was parotid enlargement (7 cases). Hypergammaglobulinemia and the presence of the rheumatoid factor were both found in 6 out of the 10 patients, while lymphopenia was found in 5 out of 10 patients.</div><div class='html-p'>Seven patients were treated with either rituximab, chemotherapy, or complementary radiotherapy, while the other three were monitored for the evolution of disease (MALT lymphoma and nodal marginal zone type). Complete remission was achieved in 3 MALT lymphoma cases and 1 DLBCL after initial treatment, as seen in <a href="#rheumato-04-00012-t003" class="html-table">Table 3</a>. Partial response was seen in 1 MALT lymphoma after rituximab. In total, 4 out of the 10 patients had a relapse of their lymphoma. In total, 1 patient expired as a result of lymphoma, while 4 of 10 patients expired due to illnesses that were not directly related to their lymphoma diagnosis.</div></section><section id='sec4-rheumato-04-00012' type='discussion'><h2 data-nested='1'> 4. Discussion</h2><div class='html-p'>The prevalence of lymphoma in our SjD patients was comparable to estimates of approximately 5–8% reported in other studies [<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>]. SjD, like many autoimmune disorders, exhibits a higher prevalence in females [<a href="#B14-rheumato-04-00012" class="html-bibr">14</a>]. Within our series, there was only one male patient. Interestingly, this patient exhibited the highest number of suggested predictors associated with the development of lymphoma, as can be seen in <a href="#rheumato-04-00012-t002" class="html-table">Table 2</a>. He was also the only patient to expire as a result of lymphoma progression. In addition to palpable purpura, this patient presented with parotid gland swelling and low complement four levels. This case not only underscores the role of these risk factors in lymphoma development but also suggests a potential association between disease activity, progression, and sex. A study completed in Korea investigating the extraglandular manifestations of SjD in men found a notably higher prevalence of lymphoma among males compared to females (9.1% vs. 0.3%, <span class='html-italic'>p</span> = 0.002) [<a href="#B15-rheumato-04-00012" class="html-bibr">15</a>]. Anaya et al. reported the prevalence of lymphoma in males with isolated SjD to be as high as 15.4% [<a href="#B16-rheumato-04-00012" class="html-bibr">16</a>]. This further supports the idea that sex plays a role in disease manifestations, and males may have a higher than suspected risk of lymphoma development.</div><div class='html-p'>Age has also been thought to play a part in lymphoma development. A study by Ramos-Casals et al. showed that patients who developed SjD earlier in life had a greater risk of lymphoma development, though subsequent studies did not support this theory [<a href="#B17-rheumato-04-00012" class="html-bibr">17</a>]. A more recent study involving 1997 patients by Goules et al. revealed that those with disease onset before the age of 35 or after age 65 had an increased incidence of lymphoma compared to those diagnosed with Sjogren’s Disease between ages 36 and 64 [<a href="#B18-rheumato-04-00012" class="html-bibr">18</a>]. Although Goules’ study highlighted a bimodal age distribution, the majority of our patients were diagnosed between ages 35 and 64.</div><div class='html-p'>The clinical manifestations that have been associated with lymphoma risk include the persistent enlargement of the parotid or lacrimal glands, chronic lymphadenopathy, palpable purpura, splenomegaly, and peripheral neuropathy [<a href="#B19-rheumato-04-00012" class="html-bibr">19</a>,<a href="#B20-rheumato-04-00012" class="html-bibr">20</a>,<a href="#B21-rheumato-04-00012" class="html-bibr">21</a>]. Early studies have indicated that persistent parotid gland swelling is associated with an increased risk of lymphoma. The relative risk (RR) of lymphoma development in these patients is 66.7, as opposed to 12.5 for SjD patients without parotid enlargement [<a href="#B22-rheumato-04-00012" class="html-bibr">22</a>]. Moreover, findings from a large multicenter Italian study suggest that the significance of parotid swelling is dependent on the coexpression of laboratory markers, such as leukopenia, low C4 levels, positive SSA/SSB, or cryoglobulinemia. This study reported that the presence of 2 out of these 4 biomarkers in patients with parotid gland swelling correlated with a nine-fold increase in lymphoma risk, while the absence of any markers yielded a negative predictive value of approximately 90% [<a href="#B23-rheumato-04-00012" class="html-bibr">23</a>]. Within our series, 7 out of 10 patients exhibited persistent parotid swelling, all of whom also presented with at least two additional predictive prognostic factors.</div><div class='html-p'>Laboratory findings that have been associated with lymphoma development include ANA positivity, the rheumatoid factor (RF), the presence of lymphopenia defined as an absolute lymphocyte count <1000/mm<sup>3</sup>, hypergammaglobulinemia, circulating monoclonal proteins in serum or urine, cryoglobulinemia, and hypocomplementemia [<a href="#B19-rheumato-04-00012" class="html-bibr">19</a>,<a href="#B20-rheumato-04-00012" class="html-bibr">20</a>,<a href="#B21-rheumato-04-00012" class="html-bibr">21</a>]. In the cellular pathway involved in the lymphomagenesis of Sjogren’s Disease, abnormal B-cell maturation leads to the generation of self-reactive B-cells. This prolonged survival of autoreactive B-cells leads to the production of autoantibodies and the rheumatoid factor, which are thought to be associated with lymphoma development [<a href="#B24-rheumato-04-00012" class="html-bibr">24</a>]. Prior to a study in 2015, an association between the presence of rheumatoid factors and the development of lymphoma had not been reported. In a study by Nocturne et al., the rheumatoid factor was detected in approximately two-thirds of lymphoma patients, suggesting its potential use as a predictive marker. Given that RF is easy to obtain and cost-effective compared to other assays, such as cryoglobulins, it holds promise for patient monitoring [<a href="#B21-rheumato-04-00012" class="html-bibr">21</a>]. In our series, 60% of patients had a positive rheumatoid factor, further supporting its utility as a risk factor for lymphoma development in this patient population.</div><div class='html-p'>Because the prevalence of ANA in SjD is estimated to be as high as 80%, it is difficult to evaluate the sensitivity of ANA as a predictive marker [<a href="#B25-rheumato-04-00012" class="html-bibr">25</a>,<a href="#B26-rheumato-04-00012" class="html-bibr">26</a>]. Nevertheless, studies, including that by Wan et al., have indicated an increased prevalence of positive ANA in lymphoma patients independent of SjD, suggesting a potential relationship between ANA positivity and lymphomagenesis [<a href="#B27-rheumato-04-00012" class="html-bibr">27</a>]. A recent study by Frost et al. observed that a positive ANA was associated with a higher risk of developing DLBCL. Stratified analyses suggest that this association may even be stronger in males compared to females. Although no association between ANA and other subtypes of lymphoma aside from DLBCL was found in their study, anti-SSA and anti-dsdna were found to be associated with DLBCL and MZL [<a href="#B28-rheumato-04-00012" class="html-bibr">28</a>].</div><div class='html-p'>Lymphopenia has been observed more frequently in SjD patients who develop lymphoma [<a href="#B29-rheumato-04-00012" class="html-bibr">29</a>]. In a study by Fragkioudaki, SjD NHL occurrence was associated with lymphopenia (28.3% in patients with NHL vs. 11.6% in SjD patients without a diagnosis of lymphoma, <span class='html-italic'>p</span> < 0.001) [<a href="#B30-rheumato-04-00012" class="html-bibr">30</a>]. Similarly, Baimpa et al. reported the presence of lymphopenia as a risk factor for the development of non-MZBCLs (marginal zone B-cell lymphomas), particularly DLBCL (<span class='html-italic'>p</span> = 0.044) [<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>]. In our series, 50% of patients exhibited lymphopenia. However, among these patients, only one developed DLBCL, while three had MALT, and one developed MZL. Although our findings do not align with previous studies regarding the lymphoma subtype, lymphopenia remains a significant hematologic abnormality potentially indicative of disease development.</div><div class='html-p'>Malignancies, particularly lymphoma and lymphoproliferative disorders, are commonly associated with polyclonal hypergammaglobulinemia. This abnormality is also prevalent in autoimmune diseases and is one of the most common hematologic manifestations found in SjD, thought to be a direct result of continuous IL-6 stimulation and B cell activation [<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>,<a href="#B31-rheumato-04-00012" class="html-bibr">31</a>,<a href="#B32-rheumato-04-00012" class="html-bibr">32</a>]. Hypergammaglobulinemia also correlates with extraglandular manifestations, such as splenomegaly [<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>]. Moreover, there is a perceived association between hypergammaglobulinemia, RF positivity, and the presence of both SSA and SSB [<a href="#B33-rheumato-04-00012" class="html-bibr">33</a>,<a href="#B34-rheumato-04-00012" class="html-bibr">34</a>]. This suggests that these markers may collectively hold predictive value for malignancy development. In our study, 6 out of 10 patients exhibited elevated immunoglobulin levels. However, all of these patients also presented with at least two additional potential predictive markers alongside hypergammaglobulinemia.</div><div class='html-p'>There is notable diversity in the progression of lymphoproliferative disorders in SjD, which encompasses several lymphoma subtypes observed in prior studies and in our data. The predominant subtypes, accounting for more than 90% of reported cases in primary Sjogren’s Disease, include MALT lymphoma, DLBCL, and MZL [<a href="#B10-rheumato-04-00012" class="html-bibr">10</a>]. Most studies indicate that the most common type of lymphoma seen in SjD is MALT lymphoma [<a href="#B3-rheumato-04-00012" class="html-bibr">3</a>,<a href="#B35-rheumato-04-00012" class="html-bibr">35</a>,<a href="#B36-rheumato-04-00012" class="html-bibr">36</a>], as was seen in our patients. In total, 50% had MALT, while 30% were diagnosed with DLBCL, 10% had NSHL, and 10% had MZL. MALT lymphoma generally carries a more favorable prognosis compared to DLBCL in isolated Sjogren’s Disease [<a href="#B37-rheumato-04-00012" class="html-bibr">37</a>]. The relative risk of developing lymphoma for SjD is estimated to be up to 16 times higher than the general population [<a href="#B31-rheumato-04-00012" class="html-bibr">31</a>]. The risk of lymphoma development is maintained at high levels even 10–15 years after SjD diagnosis [<a href="#B38-rheumato-04-00012" class="html-bibr">38</a>]. And it appears to increase with disease duration, with the cumulative risk of developing lymphoma at around 3.4% in the first 5 years and approximately 9.8% within 15 years after initial SjD diagnosis [<a href="#B31-rheumato-04-00012" class="html-bibr">31</a>]. Our data show that out of the 10 patients who were diagnosed with lymphoma, 2 were diagnosed within 5 years of their initial SjD diagnosis, 3 were diagnosed within 5–15 years after their SjD diagnosis, and 5 were diagnosed more than 15 years after their SjD diagnosis. Furthermore, while the mean time between SjD diagnosis and the development of lymphoma in our series was 14.3 years ± 7.9, the duration of time ranged from 1 year to 25 years, further supporting the need for long-term monitoring. Additionally, within our series, patients with MALT lymphoma were diagnosed at an earlier age, as opposed to patients with non-MALT lymphoma.</div><div class='html-p'>This high-risk population should undergo regular screening for lymphoma risk features. Some have suggested biannual monitoring with clinic visits and comprehensive laboratory assessments, which may include a complete blood count, ANA, RF, quantitative immunoglobulins, C4, assessment for monoclonal gammopathy, and cryoglobulins. On average, our patients who developed lymphoma had 3.3 of these laboratory findings. A physical exam should also focus on parotid gland swelling, peripheral neuropathy, palpable purpura, and splenomegaly. Since lymphoma presentation was variable, with patients demonstrating persistent swelling of the parotid gland, conjunctival mass, lymphadenopathy, and abdominal pain, additional concern should be paid to these regions.</div><div class='html-p'>The limitations of our study included a small sample size of 10 patients with lymphoma. This study was also retrospective, and some laboratory assays were not collected for all patients.</div></section><section id='sec5-rheumato-04-00012' type='conclusions'><h2 data-nested='1'> 5. Conclusions</h2><div class='html-p'>Approximately 1 out of every 5 deaths in patients with SjD is caused by lymphoma [<a href="#B9-rheumato-04-00012" class="html-bibr">9</a>,<a href="#B39-rheumato-04-00012" class="html-bibr">39</a>]. Our series appears to be representative of the prevalence, associated risk factors, and clinical presentation of the development of lymphoma in Sjogren’s Disease. This includes less-appreciated presentations involving the ocular conjunctiva, abdomen, and lung. The sustained risk justifies the need for long-term monitoring of features of lymphoma, as well as providing education and awareness in order to achieve the early diagnosis of a potentially lethal malignancy.</div></section> </div> <div class="html-back"> <section class='html-notes'><h2 >Author Contributions</h2><div class='html-p'>Conceptualization, L.B, J.B. and S.E.C.; methodology J.B. and L.B.; investigation, L.B. and J.B.; original manuscript writing—L.B., J.B. and S.E.C.; manuscript writing—review and editing, J.B.; supervision, S.E.C. All authors have read and agreed to the published version of the manuscript.</div></section><section class='html-notes'><h2>Funding</h2><div class='html-p'>This research received no external funding.</div></section><section class='html-notes'><h2 >Institutional Review Board Statement</h2><div class='html-p'>This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (NYU Winthrop Hospital s19-0881 Approved 13 June 2019).</div></section><section class='html-notes'><h2 >Informed Consent Statement</h2><div class='html-p'>This study received a waiver of consent. A waiver of consent was utilized because the study involved minimal risk to subjects and would not be able to be otherwise performed.</div></section><section class='html-notes'><h2 >Data Availability Statement</h2><div class='html-p'>The original contributions presented in the study are included in the article; further inquiries can be directed to the corresponding author/s.</div></section><section class='html-notes'><h2 >Conflicts of Interest</h2><div class='html-p'>Carsons received research funding from Novartis and Bristol Myers Squibb and is a consultant for Kiniksa Inc. on topics not directly related to this publication.</div></section><section id='html-references_list'><h2>References</h2><ol class='html-xx'><li id='B1-rheumato-04-00012' class='html-x' data-content='1.'>Skopouli, F.N.; Dafni, U.; Ioannidis, J.P.; Moutsopoulos, H.M. Clinical evolution, and morbidity and mortality of primary Sjögren’s syndrome. <span class='html-italic'>Semin. Arthritis Rheum.</span> <b>2000</b>, <span class='html-italic'>29</span>, 296–304. [<a href="https://scholar.google.com/scholar_lookup?title=Clinical+evolution,+and+morbidity+and+mortality+of+primary+Sj%C3%B6gren%E2%80%99s+syndrome&author=Skopouli,+F.N.&author=Dafni,+U.&author=Ioannidis,+J.P.&author=Moutsopoulos,+H.M.&publication_year=2000&journal=Semin.+Arthritis+Rheum.&volume=29&pages=296%E2%80%93304&doi=10.1016/S0049-0172(00)80016-5&pmid=10805354" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/S0049-0172(00)80016-5" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/10805354" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B2-rheumato-04-00012' class='html-x' data-content='2.'>Lesley, R.; Xu, Y.; Kalled, S.L.; Hess, D.M.; Schwab, S.R.; Shu, H.B.; Cyster, J.G. Reduced competitiveness of autoantigen-engaged B cells due to increased dependence on BAFF. <span class='html-italic'>Immunity</span> <b>2004</b>, <span class='html-italic'>20</span>, 441–453. [<a href="https://scholar.google.com/scholar_lookup?title=Reduced+competitiveness+of+autoantigen-engaged+B+cells+due+to+increased+dependence+on+BAFF&author=Lesley,+R.&author=Xu,+Y.&author=Kalled,+S.L.&author=Hess,+D.M.&author=Schwab,+S.R.&author=Shu,+H.B.&author=Cyster,+J.G.&publication_year=2004&journal=Immunity&volume=20&pages=441%E2%80%93453&doi=10.1016/S1074-7613(04)00079-2&pmid=15084273" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/S1074-7613(04)00079-2" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/15084273" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B3-rheumato-04-00012' class='html-x' data-content='3.'>Smedby, K.E.; Hjalgrim, H.; Askling, J.; Chang, E.T.; Gregersen, H.; Porwit-MacDonald, A.; Sundstrom, C.; Akerman, M.; Melbye, M.; Glimelius, B.; et al. Autoimmune and chronic inflammatory disorders and risk of non-Hodgkin lymphoma by subtype. <span class='html-italic'>J. Nat. Cancer Inst.</span> <b>2006</b>, <span class='html-italic'>98</span>, 51–60. [<a href="https://scholar.google.com/scholar_lookup?title=Autoimmune+and+chronic+inflammatory+disorders+and+risk+of+non-Hodgkin+lymphoma+by+subtype&author=Smedby,+K.E.&author=Hjalgrim,+H.&author=Askling,+J.&author=Chang,+E.T.&author=Gregersen,+H.&author=Porwit-MacDonald,+A.&author=Sundstrom,+C.&author=Akerman,+M.&author=Melbye,+M.&author=Glimelius,+B.&publication_year=2006&journal=J.+Nat.+Cancer+Inst.&volume=98&pages=51%E2%80%9360&doi=10.1093/jnci/djj004" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1093/jnci/djj004" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B4-rheumato-04-00012' class='html-x' data-content='4.'>Fallah, M.; Liu, X.; Ji, J.; Forsti, A.; Sundquist, K.; Hemminki, K. Autoimmune diseases associated with non-Hodgkin lymphoma: A nationwide cohort study. <span class='html-italic'>Ann. Oncol.</span> <b>2014</b>, <span class='html-italic'>25</span>, 2025–2030. [<a href="https://scholar.google.com/scholar_lookup?title=Autoimmune+diseases+associated+with+non-Hodgkin+lymphoma:+A+nationwide+cohort+study&author=Fallah,+M.&author=Liu,+X.&author=Ji,+J.&author=Forsti,+A.&author=Sundquist,+K.&author=Hemminki,+K.&publication_year=2014&journal=Ann.+Oncol.&volume=25&pages=2025%E2%80%932030&doi=10.1093/annonc/mdu365&pmid=25081899" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1093/annonc/mdu365" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/25081899" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B5-rheumato-04-00012' class='html-x' data-content='5.'>Johnsen, S.J.; Brun, J.G.; Goransson, L.G.; Smastuen, M.C.; Johannesen, T.B.; Haldorsen, K.; Harboe, E.; Jonsson, R.; Meyer, P.A.; Omdal, R. Risk of non-Hodgkin’s lymphoma in primary Sjögren’s syndrome: A population-based study. <span class='html-italic'>Arthritis Care Res.</span> <b>2013</b>, <span class='html-italic'>65</span>, 816–821. [<a href="https://scholar.google.com/scholar_lookup?title=Risk+of+non-Hodgkin%E2%80%99s+lymphoma+in+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+A+population-based+study&author=Johnsen,+S.J.&author=Brun,+J.G.&author=Goransson,+L.G.&author=Smastuen,+M.C.&author=Johannesen,+T.B.&author=Haldorsen,+K.&author=Harboe,+E.&author=Jonsson,+R.&author=Meyer,+P.A.&author=Omdal,+R.&publication_year=2013&journal=Arthritis+Care+Res.&volume=65&pages=816%E2%80%93821&doi=10.1002/acr.21887" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1002/acr.21887" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B6-rheumato-04-00012' class='html-x' data-content='6.'>Theander, E.; Henriksson, G.; Ljungberg, O.; Mandl, T.; Manthorpe, R.; Jacobsson, L.T. Lymphoma and other malignancies in primary Sjögren’s syndrome: A cohort study on cancer incidence and lymphoma predictors. <span class='html-italic'>Ann. Rheum. Dis.</span> <b>2006</b>, <span class='html-italic'>65</span>, 796–803. [<a href="https://scholar.google.com/scholar_lookup?title=Lymphoma+and+other+malignancies+in+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+A+cohort+study+on+cancer+incidence+and+lymphoma+predictors&author=Theander,+E.&author=Henriksson,+G.&author=Ljungberg,+O.&author=Mandl,+T.&author=Manthorpe,+R.&author=Jacobsson,+L.T.&publication_year=2006&journal=Ann.+Rheum.+Dis.&volume=65&pages=796%E2%80%93803&doi=10.1136/ard.2005.041186" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1136/ard.2005.041186" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B7-rheumato-04-00012' class='html-x' data-content='7.'>Tzioufas, A.G.; Voulgarelis, M. Update on Sjögren’s syndrome autoimmune epithelitis: From classification to increased neoplasias. <span class='html-italic'>Best Pract. Res. Clin. Rheumatol.</span> <b>2007</b>, <span class='html-italic'>21</span>, 989–1010. [<a href="https://scholar.google.com/scholar_lookup?title=Update+on+Sj%C3%B6gren%E2%80%99s+syndrome+autoimmune+epithelitis:+From+classification+to+increased+neoplasias&author=Tzioufas,+A.G.&author=Voulgarelis,+M.&publication_year=2007&journal=Best+Pract.+Res.+Clin.+Rheumatol.&volume=21&pages=989%E2%80%931010&doi=10.1016/j.berh.2007.09.001" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.berh.2007.09.001" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B8-rheumato-04-00012' class='html-x' data-content='8.'>Retamozo, S.; Brito-Zeron, P.; Ramos-Casals, M. Prognostic markers of lymphoma development in primary Sjogren syndrome. <span class='html-italic'>Lupus</span> <b>2019</b>, <span class='html-italic'>28</span>, 923–936. [<a href="https://scholar.google.com/scholar_lookup?title=Prognostic+markers+of+lymphoma+development+in+primary+Sjogren+syndrome&author=Retamozo,+S.&author=Brito-Zeron,+P.&author=Ramos-Casals,+M.&publication_year=2019&journal=Lupus&volume=28&pages=923%E2%80%93936&doi=10.1177/0961203319857132" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1177/0961203319857132" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B9-rheumato-04-00012' class='html-x' data-content='9.'>Vivino, F.B. Sjogren’s syndrome: Clinical aspects. <span class='html-italic'>Clin. Immunol.</span> <b>2017</b>, <span class='html-italic'>182</span>, 48–54. [<a href="https://scholar.google.com/scholar_lookup?title=Sjogren%E2%80%99s+syndrome:+Clinical+aspects&author=Vivino,+F.B.&publication_year=2017&journal=Clin.+Immunol.&volume=182&pages=48%E2%80%9354&doi=10.1016/j.clim.2017.04.005" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.clim.2017.04.005" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B10-rheumato-04-00012' class='html-xx' data-content='10.'>Baimpa, E.; Dahabreh, I.J.; Voulgarelis, M.; Moutsopoulos, H.M. Hematologic manifestations and predictors of lymphoma development in primary Sjogren syndrome: Clinical and pathophysiologic aspects. <span class='html-italic'>Medicine</span> <b>2009</b>, <span class='html-italic'>88</span>, 284–293. [<a href="https://scholar.google.com/scholar_lookup?title=Hematologic+manifestations+and+predictors+of+lymphoma+development+in+primary+Sjogren+syndrome:+Clinical+and+pathophysiologic+aspects&author=Baimpa,+E.&author=Dahabreh,+I.J.&author=Voulgarelis,+M.&author=Moutsopoulos,+H.M.&publication_year=2009&journal=Medicine&volume=88&pages=284%E2%80%93293&doi=10.1097/MD.0b013e3181b76ab5" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1097/MD.0b013e3181b76ab5" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B11-rheumato-04-00012' class='html-xx' data-content='11.'>Wu, T.; Li, S.; Chen, J.; Liao, J.; Huang, Z.; Yang, J.; Zhang, Y.; He, Q.; Yu, X.; Song, W.; et al. A bibliometric analysis of primary Sjögren’s syndrome-associated lymphoma from 1991 to 2022. <span class='html-italic'>Heliyon</span> <b>2023</b>, <span class='html-italic'>9</span>, e21337. [<a href="https://scholar.google.com/scholar_lookup?title=A+bibliometric+analysis+of+primary+Sj%C3%B6gren%E2%80%99s+syndrome-associated+lymphoma+from+1991+to+2022&author=Wu,+T.&author=Li,+S.&author=Chen,+J.&author=Liao,+J.&author=Huang,+Z.&author=Yang,+J.&author=Zhang,+Y.&author=He,+Q.&author=Yu,+X.&author=Song,+W.&publication_year=2023&journal=Heliyon&volume=9&pages=e21337&doi=10.1016/j.heliyon.2023.e21337&pmid=37964859" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.heliyon.2023.e21337" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/37964859" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B12-rheumato-04-00012' class='html-xx' data-content='12.'>Tonami, H.; Matoba, M.; Kuginuki, Y.; Yokota, H.; Higashi, K.; Yamamoto, I.; Sugai, S. Clinical and imaging findings of lymphoma in patients with Sjogren syndrome. <span class='html-italic'>J. Comput. Assist. Tomogr.</span> <b>2003</b>, <span class='html-italic'>27</span>, 517–524. [<a href="https://scholar.google.com/scholar_lookup?title=Clinical+and+imaging+findings+of+lymphoma+in+patients+with+Sjogren+syndrome&author=Tonami,+H.&author=Matoba,+M.&author=Kuginuki,+Y.&author=Yokota,+H.&author=Higashi,+K.&author=Yamamoto,+I.&author=Sugai,+S.&publication_year=2003&journal=J.+Comput.+Assist.+Tomogr.&volume=27&pages=517%E2%80%93524&doi=10.1097/00004728-200307000-00011" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1097/00004728-200307000-00011" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B13-rheumato-04-00012' class='html-xx' data-content='13.'>Lynch, R.C.; Gratzinger, D.; Advani, R.H. Clinical Impact of the 2016 Update to the WHO Lymphoma Classification. <span class='html-italic'>Curr. Treat. Options Oncol.</span> <b>2017</b>, <span class='html-italic'>18</span>, 45. [<a href="https://scholar.google.com/scholar_lookup?title=Clinical+Impact+of+the+2016+Update+to+the+WHO+Lymphoma+Classification&author=Lynch,+R.C.&author=Gratzinger,+D.&author=Advani,+R.H.&publication_year=2017&journal=Curr.+Treat.+Options+Oncol.&volume=18&pages=45&doi=10.1007/s11864-017-0483-z" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1007/s11864-017-0483-z" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B14-rheumato-04-00012' class='html-xx' data-content='14.'>Patel, R.; Shahane, A. The epidemiology of Sjögren’s syndrome. <span class='html-italic'>Clin. Epidemiol.</span> <b>2014</b>, <span class='html-italic'>30</span>, 247–255. [<a href="https://scholar.google.com/scholar_lookup?title=The+epidemiology+of+Sj%C3%B6gren%E2%80%99s+syndrome&author=Patel,+R.&author=Shahane,+A.&publication_year=2014&journal=Clin.+Epidemiol.&volume=30&pages=247%E2%80%93255" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>]</li><li id='B15-rheumato-04-00012' class='html-xx' data-content='15.'>Park, Y.; Lee, J.; Park, S.H.; Kwok, S.K. Male patients with primary Sjögren’s syndrome: A distinct clinical subgroup? <span class='html-italic'>Int. J. Rheum. Dis.</span> <b>2020</b>, <span class='html-italic'>23</span>, 1388–1395. [<a href="https://scholar.google.com/scholar_lookup?title=Male+patients+with+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+A+distinct+clinical+subgroup?&author=Park,+Y.&author=Lee,+J.&author=Park,+S.H.&author=Kwok,+S.K.&publication_year=2020&journal=Int.+J.+Rheum.+Dis.&volume=23&pages=1388%E2%80%931395&doi=10.1111/1756-185X.13940" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1111/1756-185X.13940" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B16-rheumato-04-00012' class='html-xx' data-content='16.'>Anaya, J.M.; Liu, G.T.; D’Souza, E.; Ogawa, N.; Luan, X.; Talal, N. Primary Sjögren’s syndrome in men. <span class='html-italic'>Ann. Rheum. Dis.</span> <b>1995</b>, <span class='html-italic'>54</span>, 748–751. [<a href="https://scholar.google.com/scholar_lookup?title=Primary+Sj%C3%B6gren%E2%80%99s+syndrome+in+men&author=Anaya,+J.M.&author=Liu,+G.T.&author=D%E2%80%99Souza,+E.&author=Ogawa,+N.&author=Luan,+X.&author=Talal,+N.&publication_year=1995&journal=Ann.+Rheum.+Dis.&volume=54&pages=748%E2%80%93751&doi=10.1136/ard.54.9.748&pmid=7495348" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1136/ard.54.9.748" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/7495348" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B17-rheumato-04-00012' class='html-xx' data-content='17.'>Ramos-Casals, M.; Cervera, R.; Font, J.; Garcia-Carrasco, M.; Espinosa, G.; Pallares, L.; Ingelmo, M. Young onset of primary Sjögren’s syndrome: Clinical and immunological characteristics. <span class='html-italic'>Lupus</span> <b>1998</b>, <span class='html-italic'>73</span>, 202–206. [<a href="https://scholar.google.com/scholar_lookup?title=Young+onset+of+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+Clinical+and+immunological+characteristics&author=Ramos-Casals,+M.&author=Cervera,+R.&author=Font,+J.&author=Garcia-Carrasco,+M.&author=Espinosa,+G.&author=Pallares,+L.&author=Ingelmo,+M.&publication_year=1998&journal=Lupus&volume=73&pages=202%E2%80%93206&doi=10.1191/096120398678920019" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1191/096120398678920019" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B18-rheumato-04-00012' class='html-xx' data-content='18.'>Goules, A.V.; Argyropoulou, O.D.; Pezoulas, V.C.; Chatzis, L.; Critselis, E.; Gandolfo, S.; Ferro, F.; Binutti, M.; Donati, V.; Callegher, S.Z.; et al. Primary Sjögren’s syndrome of early and late onset: Distinct clinical phenotypes and lymphoma development. <span class='html-italic'>Front. Immunol.</span> <b>2020</b>, <span class='html-italic'>11</span>, 594096. [<a href="https://scholar.google.com/scholar_lookup?title=Primary+Sj%C3%B6gren%E2%80%99s+syndrome+of+early+and+late+onset:+Distinct+clinical+phenotypes+and+lymphoma+development&author=Goules,+A.V.&author=Argyropoulou,+O.D.&author=Pezoulas,+V.C.&author=Chatzis,+L.&author=Critselis,+E.&author=Gandolfo,+S.&author=Ferro,+F.&author=Binutti,+M.&author=Donati,+V.&author=Callegher,+S.Z.&publication_year=2020&journal=Front.+Immunol.&volume=11&pages=594096&doi=10.3389/fimmu.2020.594096" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.3389/fimmu.2020.594096" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B19-rheumato-04-00012' class='html-xx' data-content='19.'>Fauchais, A.L.; Martel, C.; Gondran, G.; Lambert, M.; Launay, D.; Jauberteau, M.O.; Hachulla, E.; Vidal, E.; Hatron, P.Y. Immunological profile in primary Sjögren syndrome: Clinical significance, prognosis and long-term evolution to other auto-immune disease. <span class='html-italic'>Autoimmun. Rev.</span> <b>2010</b>, <span class='html-italic'>9</span>, 595–599. [<a href="https://scholar.google.com/scholar_lookup?title=Immunological+profile+in+primary+Sj%C3%B6gren+syndrome:+Clinical+significance,+prognosis+and+long-term+evolution+to+other+auto-immune+disease&author=Fauchais,+A.L.&author=Martel,+C.&author=Gondran,+G.&author=Lambert,+M.&author=Launay,+D.&author=Jauberteau,+M.O.&author=Hachulla,+E.&author=Vidal,+E.&author=Hatron,+P.Y.&publication_year=2010&journal=Autoimmun.+Rev.&volume=9&pages=595%E2%80%93599&doi=10.1016/j.autrev.2010.05.004" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.autrev.2010.05.004" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B20-rheumato-04-00012' class='html-xx' data-content='20.'>Varin, M.M.; Le Pottier, L.; Youinou, P.; Saulep, D.; Mackay, F.; Per, J.O. B-cell tolerance breakdown in Sjogren’s syndrome: Focus on BAFF. <span class='html-italic'>Autoimmun. Rev.</span> <b>2010</b>, <span class='html-italic'>9</span>, 604–608. [<a href="https://scholar.google.com/scholar_lookup?title=B-cell+tolerance+breakdown+in+Sjogren%E2%80%99s+syndrome:+Focus+on+BAFF&author=Varin,+M.M.&author=Le+Pottier,+L.&author=Youinou,+P.&author=Saulep,+D.&author=Mackay,+F.&author=Per,+J.O.&publication_year=2010&journal=Autoimmun.+Rev.&volume=9&pages=604%E2%80%93608&doi=10.1016/j.autrev.2010.05.006" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.autrev.2010.05.006" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B21-rheumato-04-00012' class='html-xx' data-content='21.'>Nocturne, G.; Virone, A.; Ng, W.F.; Le Guern, V.; Hachulla, E.; Cornec, D.; Daien, C.; Vittecoq, O.; Bienvenu, B.; Marcelli, C.; et al. Rheumatoid Factor and Disease Activity Are Independent Predictors of Lymphoma in Primary Sjogren’s Syndrome. <span class='html-italic'>Arthritis Rheumatol.</span> <b>2016</b>, <span class='html-italic'>68</span>, 977–985. [<a href="https://scholar.google.com/scholar_lookup?title=Rheumatoid+Factor+and+Disease+Activity+Are+Independent+Predictors+of+Lymphoma+in+Primary+Sjogren%E2%80%99s+Syndrome&author=Nocturne,+G.&author=Virone,+A.&author=Ng,+W.F.&author=Le+Guern,+V.&author=Hachulla,+E.&author=Cornec,+D.&author=Daien,+C.&author=Vittecoq,+O.&author=Bienvenu,+B.&author=Marcelli,+C.&publication_year=2016&journal=Arthritis+Rheumatol.&volume=68&pages=977%E2%80%93985&doi=10.1002/art.39518" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1002/art.39518" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B22-rheumato-04-00012' class='html-xx' data-content='22.'>Kassan, S.S.; Thomas, T.L.; Moutsopoulos, H.M.; Hoover, R.; Kimberly, R.P.; Budman, D.R.; Costa, J.; Decker, J.L.; Chused, T.M. Increased risk of lymphoma in sicca syndrome. <span class='html-italic'>Ann. Intern. Med.</span> <b>1978</b>, <span class='html-italic'>89</span>, 888–892. [<a href="https://scholar.google.com/scholar_lookup?title=Increased+risk+of+lymphoma+in+sicca+syndrome&author=Kassan,+S.S.&author=Thomas,+T.L.&author=Moutsopoulos,+H.M.&author=Hoover,+R.&author=Kimberly,+R.P.&author=Budman,+D.R.&author=Costa,+J.&author=Decker,+J.L.&author=Chused,+T.M.&publication_year=1978&journal=Ann.+Intern.+Med.&volume=89&pages=888%E2%80%93892&doi=10.7326/0003-4819-89-6-888&pmid=102228" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.7326/0003-4819-89-6-888" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/102228" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B23-rheumato-04-00012' class='html-xx' data-content='23.'>Quartuccio, L.; Isola, M.; Baldini, C.; Priori, R.; Bartoloni Bocci, E.; Carubbi, F.; Maset, M.; Gregoraci, G.; Della Mea, V.; Salvin, S.; et al. Biomarkers of lymphoma in Sjögren’s syndrome and evaluation of the lymphoma risk in prelymphomatous conditions: Results of a multicenter study. <span class='html-italic'>J. Autoimmun.</span> <b>2014</b>, <span class='html-italic'>51</span>, 75–80. [<a href="https://scholar.google.com/scholar_lookup?title=Biomarkers+of+lymphoma+in+Sj%C3%B6gren%E2%80%99s+syndrome+and+evaluation+of+the+lymphoma+risk+in+prelymphomatous+conditions:+Results+of+a+multicenter+study&author=Quartuccio,+L.&author=Isola,+M.&author=Baldini,+C.&author=Priori,+R.&author=Bartoloni+Bocci,+E.&author=Carubbi,+F.&author=Maset,+M.&author=Gregoraci,+G.&author=Della+Mea,+V.&author=Salvin,+S.&publication_year=2014&journal=J.+Autoimmun.&volume=51&pages=75%E2%80%9380&doi=10.1016/j.jaut.2013.10.002&pmid=24231556" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.jaut.2013.10.002" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/24231556" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B24-rheumato-04-00012' class='html-xx' data-content='24.'>Routsias, J.G.; Goules, J.D.; Charalampakis, G.; Tzima, S.; Papageorgiou, A.; Voulgarelis, M. Malignant lymphoma in primary Sjögren’s syndrome: An update on the pathogenesis and treatment. Semin. <span class='html-italic'>Arthritis Rheum.</span> <b>2013</b>, <span class='html-italic'>43</span>, 178–186. [<a href="https://scholar.google.com/scholar_lookup?title=Malignant+lymphoma+in+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+An+update+on+the+pathogenesis+and+treatment.+Semin&author=Routsias,+J.G.&author=Goules,+J.D.&author=Charalampakis,+G.&author=Tzima,+S.&author=Papageorgiou,+A.&author=Voulgarelis,+M.&publication_year=2013&journal=Arthritis+Rheum.&volume=43&pages=178%E2%80%93186&doi=10.1016/j.semarthrit.2013.04.004&pmid=23816048" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.semarthrit.2013.04.004" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/23816048" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B25-rheumato-04-00012' class='html-xx' data-content='25.'>Nardi, N.; Brito-Zerón, P.; Ramos-Casals, M.; Aguiló, S.; Cervera, R.; Ingelmo, M.; Font, J. Circulating auto-antibodies against nuclear and non-nuclear antigens in primary Sjögren’s syndrome: Prevalence and clinical significance in 335 patients. <span class='html-italic'>Clin. Rheumatol.</span> <b>2006</b>, <span class='html-italic'>25</span>, 341–346. [<a href="https://scholar.google.com/scholar_lookup?title=Circulating+auto-antibodies+against+nuclear+and+non-nuclear+antigens+in+primary+Sj%C3%B6gren%E2%80%99s+syndrome:+Prevalence+and+clinical+significance+in+335+patients&author=Nardi,+N.&author=Brito-Zer%C3%B3n,+P.&author=Ramos-Casals,+M.&author=Aguil%C3%B3,+S.&author=Cervera,+R.&author=Ingelmo,+M.&author=Font,+J.&publication_year=2006&journal=Clin.+Rheumatol.&volume=25&pages=341%E2%80%93346&doi=10.1007/s10067-005-0059-3&pmid=16249826" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1007/s10067-005-0059-3" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/16249826" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B26-rheumato-04-00012' class='html-xx' data-content='26.'>Huo, A.P.; Lin, K.C.; Chou, C.T. Predictive and prognostic value of antinuclear antibodies and rheumatoid factor in primary Sjogren’s syndrome. <span class='html-italic'>Int. J. Rheum. Dis.</span> <b>2010</b>, <span class='html-italic'>13</span>, 39–47. [<a href="https://scholar.google.com/scholar_lookup?title=Predictive+and+prognostic+value+of+antinuclear+antibodies+and+rheumatoid+factor+in+primary+Sjogren%E2%80%99s+syndrome&author=Huo,+A.P.&author=Lin,+K.C.&author=Chou,+C.T.&publication_year=2010&journal=Int.+J.+Rheum.+Dis.&volume=13&pages=39%E2%80%9347&doi=10.1111/j.1756-185X.2009.01444.x&pmid=20374383" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1111/j.1756-185X.2009.01444.x" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/20374383" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B27-rheumato-04-00012' class='html-xx' data-content='27.'>Wang, M.E.; Fan, C.M. Application of Antinuclear Antibody and Antinuclear Antibody Spectrum in Lymphoma Treatment. <span class='html-italic'>Zhongguo Shi Yan Xue Ye Xue Za Zhi</span> <b>2020</b>, <span class='html-italic'>28</span>, 861–865. [<a href="https://scholar.google.com/scholar_lookup?title=Application+of+Antinuclear+Antibody+and+Antinuclear+Antibody+Spectrum+in+Lymphoma+Treatment&author=Wang,+M.E.&author=Fan,+C.M.&publication_year=2020&journal=Zhongguo+Shi+Yan+Xue+Ye+Xue+Za+Zhi&volume=28&pages=861%E2%80%93865" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>]</li><li id='B28-rheumato-04-00012' class='html-xx' data-content='28.'>Frost, E.; Hofmann, J.N.; Huang, W.Y.; Parks, C.G.; Frazer-Abel, A.A. Antinuclear Antibodies Are Associated with an Increased Risk of Diffuse Large B-Cell Lymphoma. <span class='html-italic'>Cancers</span> <b>2023</b>, <span class='html-italic'>15</span>, 5231. [<a href="https://scholar.google.com/scholar_lookup?title=Antinuclear+Antibodies+Are+Associated+with+an+Increased+Risk+of+Diffuse+Large+B-Cell+Lymphoma&author=Frost,+E.&author=Hofmann,+J.N.&author=Huang,+W.Y.&author=Parks,+C.G.&author=Frazer-Abel,+A.A.&publication_year=2023&journal=Cancers&volume=15&pages=5231&doi=10.3390/cancers15215231" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.3390/cancers15215231" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B29-rheumato-04-00012' class='html-xx' data-content='29.'>Voulgarelis, M.; Moutsopoulos, H.M. Malignant lymphoma in primary Sjogren’s syndrome. <span class='html-italic'>IMAJ-RAMAT GAN</span> <b>2001</b>, <span class='html-italic'>3</span>, 761–766. [<a href="https://scholar.google.com/scholar_lookup?title=Malignant+lymphoma+in+primary+Sjogren%E2%80%99s+syndrome&author=Voulgarelis,+M.&author=Moutsopoulos,+H.M.&publication_year=2001&journal=IMAJ-RAMAT+GAN&volume=3&pages=761%E2%80%93766" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>]</li><li id='B30-rheumato-04-00012' class='html-xx' data-content='30.'>Fragkioudaki, S.; Mavragani, C.P.; Moutsopoulos, H.M. Predicting the risk for lymphoma development in Sjogren syndrome: An easy tool for clinical use. <span class='html-italic'>Medicine</span> <b>2016</b>, <span class='html-italic'>95</span>, e3766. [<a href="https://scholar.google.com/scholar_lookup?title=Predicting+the+risk+for+lymphoma+development+in+Sjogren+syndrome:+An+easy+tool+for+clinical+use&author=Fragkioudaki,+S.&author=Mavragani,+C.P.&author=Moutsopoulos,+H.M.&publication_year=2016&journal=Medicine&volume=95&pages=e3766&doi=10.1097/MD.0000000000003766" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1097/MD.0000000000003766" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B31-rheumato-04-00012' class='html-xx' data-content='31.'>Solans-Laqué, R.; López-Hernandez, A.; Bosch-Gil, J.A.; Palacios, A.; Campillo, M.; Vilardell-Tarres, M. Risk, predictors, and clinical characteristics of lymphoma development in primary Sjögren’s syndrome. <span class='html-italic'>Semin. Arthritis Rheum.</span> <b>2011</b>, <span class='html-italic'>41</span>, 415–423. [<a href="https://scholar.google.com/scholar_lookup?title=Risk,+predictors,+and+clinical+characteristics+of+lymphoma+development+in+primary+Sj%C3%B6gren%E2%80%99s+syndrome&author=Solans-Laqu%C3%A9,+R.&author=L%C3%B3pez-Hernandez,+A.&author=Bosch-Gil,+J.A.&author=Palacios,+A.&author=Campillo,+M.&author=Vilardell-Tarres,+M.&publication_year=2011&journal=Semin.+Arthritis+Rheum.&volume=41&pages=415%E2%80%93423&doi=10.1016/j.semarthrit.2011.04.006&pmid=21665245" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1016/j.semarthrit.2011.04.006" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/21665245" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B32-rheumato-04-00012' class='html-xx' data-content='32.'>Greipp, P.R. <span class='html-italic'>Encyclopedia of Immunology</span>, 2nd ed.; Elsevier: San Diego, CA, USA, 1998; pp. 1161–1166. [<a href="https://scholar.google.com/scholar_lookup?title=Encyclopedia+of+Immunology&author=Greipp,+P.R.&publication_year=1998" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>]</li><li id='B33-rheumato-04-00012' class='html-xx' data-content='33.'>Alexander, E.L.; Arnett, F.C.; Provost, T.; Stevens, M.B. Sjögren’s syndrome: Association of anti-SSa antibodies with vasculitis, immunologic abnormalities and serologic hyperactivity. <span class='html-italic'>Ann. Med. Int.</span> <b>1983</b>, <span class='html-italic'>98</span>, 155–159. [<a href="https://scholar.google.com/scholar_lookup?title=Sj%C3%B6gren%E2%80%99s+syndrome:+Association+of+anti-SSa+antibodies+with+vasculitis,+immunologic+abnormalities+and+serologic+hyperactivity&author=Alexander,+E.L.&author=Arnett,+F.C.&author=Provost,+T.&author=Stevens,+M.B.&publication_year=1983&journal=Ann.+Med.+Int.&volume=98&pages=155%E2%80%93159&doi=10.7326/0003-4819-98-2-155" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.7326/0003-4819-98-2-155" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B34-rheumato-04-00012' class='html-xx' data-content='34.'>Martel, C.; Gondran, G.; Launay, D.; Lalloue, F.; Palat, S.; Lambert, M.; Ly, K.; Loustaud-Ratti, V.; Bezanahary, H.; Hachulla, E.; et al. Active Immunological Profile Is Associated with Systemic Sjögren’s Syndrome. <span class='html-italic'>J. Clin. Immunol.</span> <b>2011</b>, <span class='html-italic'>31</span>, 840–847. [<a href="https://scholar.google.com/scholar_lookup?title=Active+Immunological+Profile+Is+Associated+with+Systemic+Sj%C3%B6gren%E2%80%99s+Syndrome&author=Martel,+C.&author=Gondran,+G.&author=Launay,+D.&author=Lalloue,+F.&author=Palat,+S.&author=Lambert,+M.&author=Ly,+K.&author=Loustaud-Ratti,+V.&author=Bezanahary,+H.&author=Hachulla,+E.&publication_year=2011&journal=J.+Clin.+Immunol.&volume=31&pages=840%E2%80%93847&doi=10.1007/s10875-011-9553-3" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1007/s10875-011-9553-3" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B35-rheumato-04-00012' class='html-xx' data-content='35.'>Royer, B.; Cazals-Hatem, D.; Sibilia, J.; Agbalika, F.; Cayuela, J.M.; Soussi, T.; Maloisel, F.; Clauvel, J.P.; Brouet, J.C.; Mariette, X. Lymphomas in patients with Sjogren’s syndrome are marginal zone B-cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses. <span class='html-italic'>Blood</span> <b>1997</b>, <span class='html-italic'>90</span>, 766–775. [<a href="https://scholar.google.com/scholar_lookup?title=Lymphomas+in+patients+with+Sjogren%E2%80%99s+syndrome+are+marginal+zone+B-cell+neoplasms,+arise+in+diverse+extranodal+and+nodal+sites,+and+are+not+associated+with+viruses&author=Royer,+B.&author=Cazals-Hatem,+D.&author=Sibilia,+J.&author=Agbalika,+F.&author=Cayuela,+J.M.&author=Soussi,+T.&author=Maloisel,+F.&author=Clauvel,+J.P.&author=Brouet,+J.C.&author=Mariette,+X.&publication_year=1997&journal=Blood&volume=90&pages=766%E2%80%93775&doi=10.1182/blood.V90.2.766" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1182/blood.V90.2.766" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B36-rheumato-04-00012' class='html-xx' data-content='36.'>Zintzaras, E.; Voulgarelis, M.; Moutsopoulos, H.M. The risk of lymphoma development in autoimmune diseases: A meta-analysis. <span class='html-italic'>Arch. Intern. Med.</span> <b>2005</b>, <span class='html-italic'>165</span>, 2337–2344. [<a href="https://scholar.google.com/scholar_lookup?title=The+risk+of+lymphoma+development+in+autoimmune+diseases:+A+meta-analysis&author=Zintzaras,+E.&author=Voulgarelis,+M.&author=Moutsopoulos,+H.M.&publication_year=2005&journal=Arch.+Intern.+Med.&volume=165&pages=2337%E2%80%932344&doi=10.1001/archinte.165.20.2337&pmid=16287762" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1001/archinte.165.20.2337" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/16287762" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B37-rheumato-04-00012' class='html-xx' data-content='37.'>Voulgarelis, M.; Ziakas, P.D.; Papageorgiou, A.; Baimpa, E.; Tzioufas, A.G.; Moutsopoulos, H.M. Prognosis and outcome of non-Hodgkin lymphoma in primary Sjogren syndrome. <span class='html-italic'>Medicine</span> <b>2012</b>, <span class='html-italic'>91</span>, 1–9. [<a href="https://scholar.google.com/scholar_lookup?title=Prognosis+and+outcome+of+non-Hodgkin+lymphoma+in+primary+Sjogren+syndrome&author=Voulgarelis,+M.&author=Ziakas,+P.D.&author=Papageorgiou,+A.&author=Baimpa,+E.&author=Tzioufas,+A.G.&author=Moutsopoulos,+H.M.&publication_year=2012&journal=Medicine&volume=91&pages=1%E2%80%939&doi=10.1097/MD.0b013e31824125e4&pmid=22198497" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1097/MD.0b013e31824125e4" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>] [<a href="https://www.ncbi.nlm.nih.gov/pubmed/22198497" class='cross-ref pub_med' data-typ='pmid' target='_blank' rel='noopener noreferrer'>PubMed</a>]</li><li id='B38-rheumato-04-00012' class='html-xx' data-content='38.'>Giannouli, S.; Voulgarelis, M. Predicting progression to lymphoma in Sjogren’s syndrome patients. <span class='html-italic'>Expert Rev. Clin. Immunol.</span> <b>2014</b>, <span class='html-italic'>10</span>, 501–512. [<a href="https://scholar.google.com/scholar_lookup?title=Predicting+progression+to+lymphoma+in+Sjogren%E2%80%99s+syndrome+patients&author=Giannouli,+S.&author=Voulgarelis,+M.&publication_year=2014&journal=Expert+Rev.+Clin.+Immunol.&volume=10&pages=501%E2%80%93512&doi=10.1586/1744666X.2014.872986" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1586/1744666X.2014.872986" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li><li id='B39-rheumato-04-00012' class='html-xx' data-content='39.'>Ioannidis, J.P.; Vassiliou, V.A.; Moutsopoulos, H.M. Long-Term Risk of Mortality and Lymphoproliferative Disease and Predictive Classification of Primary Sjogren’s Syndrome. <span class='html-italic'>Arthritis Rheum.</span> <b>2002</b>, <span class='html-italic'>46</span>, 741–747. [<a href="https://scholar.google.com/scholar_lookup?title=Long-Term+Risk+of+Mortality+and+Lymphoproliferative+Disease+and+Predictive+Classification+of+Primary+Sjogren%E2%80%99s+Syndrome&author=Ioannidis,+J.P.&author=Vassiliou,+V.A.&author=Moutsopoulos,+H.M.&publication_year=2002&journal=Arthritis+Rheum.&volume=46&pages=741%E2%80%93747&doi=10.1002/art.10221" class='google-scholar' target='_blank' rel='noopener noreferrer'>Google Scholar</a>] [<a href="https://doi.org/10.1002/art.10221" class='cross-ref' target='_blank' rel='noopener noreferrer'>CrossRef</a>]</li></ol></section><section id='Tables' type='display-objects'><div class="html-table-wrap" id="rheumato-04-00012-t001"> <div class="html-table_wrap_td"> <div class="html-tablepopup html-tablepopup-link" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href='#table_body_display_rheumato-04-00012-t001'> <img data-lsrc="https://pub.mdpi-res.com/img/table.png" /> <a class="html-expand html-tablepopup" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href="#table_body_display_rheumato-04-00012-t001"></a> </div> </div> <div class="html-table_wrap_discription"> <b>Table 1.</b> Clinical and epidemiological features of SjD patients with lymphoma. </div> </div> <div class="html-table_show mfp-hide " id="table_body_display_rheumato-04-00012-t001"> <div class="html-caption"><b>Table 1.</b> Clinical and epidemiological features of SjD patients with lymphoma.</div> <table > <thead ><tr ><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case/Sex/<br>Ethnicity</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Age at SjD Diagnosis</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Anti-Ro/SSA<br>Anti-La/SSB</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Time (Years) from SjD Diagnosis</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Lymphoma Subtype </th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Presentation and Site of Lymphoma</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Glandular SjD Manifestations</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Extraglandular SjD Manifestations</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Comorbidities</th></tr></thead><tbody ><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/F/Hispanic</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >41</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Positive</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Asymmetrical enlargement of parotid gland</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XF, XS, PGE</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Polyarthritis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >None</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >2/F/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >32</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Positive</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >4</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Bilateral cervical lymphadenopathy</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XS, PGE, parotitis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Anemia, bronchiectasis, polyarthritis, RP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >SLE, IBM, sarcoidosis, GERD</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >3/F/AA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >67</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Negative</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >7</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NSHL stage IVB</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >B-symptoms, supraclavicular LN, para-aortic LN</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XS, PGE</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Neuropathy</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Hypothyroidism</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >4/F/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >51</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Negative/Negative</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >21</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MZL</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >B-symptoms, monoclonal gammopathy, inguinal LN</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XF, XS</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Bronchiectasis, interstitial fibrosis, nephrocalcinosis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >IBD</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >5/M/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >32</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Negative</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >23</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL, stage III</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >B-symptoms, parotid gland enlargement, cervical LN, mediastinal LN, axillary LN, inguinal LN, retroperitoneal LN</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XF, XS, PGE</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >VL, RP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Hypothyroidism</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >6/F/AA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >42</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Positive</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >17</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Conjunctival mass, ocular inflammation, weight loss/lacrimal gland</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XF, XS</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Bronchiectasis, pulmonary fibrosis, synovitis, neuropathy</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >SLE, cryoglobulinemia GN</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >7/F/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >40</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Positive</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >14</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Intraglandular palpable mass followed by diffuse lymphadenopathy/Axillary LN</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XF, XS, sialadenitis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Neuropathy, VL</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >AH</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >8/F/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >56</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Negative</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >11</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL, stage IV</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Upper abdominal pain, anorexia, weight loss, LUQ mass</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XS, XF, PGE</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Polyarthritis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >HLD, HTN, breast cancer</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >9/F/Caucasian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >46</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Negative</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >25</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL, stage 1AE, in CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >LUQ pain, gastric mass on EGD</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XS, XF, Parotid abscess</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Tubulointerstitial nephropathy/RTA, nephrocalcinosis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >SCAD with vfib arrest, melanoma</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >10/F/Asian Indian</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >42</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Positive/Positive</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >20</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Pulmonary MALT lymphoma</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Incidental finding on CT chest, RML mass and RLL nodule</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >XS, XF</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Polyarthritis</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >HLD, GERD, vasovagal syncope</td></tr></tbody> </table> <div class='html-table_foot html-p'><div class='html-p' style='text-indent:0em;'><span class='html-fn-content'>AA, African American; AH, autoimmune hepatitis; MALT, mucosa-associated lymphoid tissue lymphoma; NSHL, nodular sclerosing Hodgkin’s lymphoma; DLBCL, diffuse large B cell lymphoma; GN, glomerulonephritis; IBD, inflammatory bowel disease; HLD, hyperlipidemia; GERD, gastroesophageal reflux disease; IBM, inclusion body myositis; PGE, parotid gland enlargement; SjD, Sjogren’s Disease; SLE, systemic lupus erythematosus; RP, Raynaud’s phenomenon; SCAD, sudden coronary artery dissection; vfib, ventricular fibrillation; VL, biopsy-proven cutaneous vasculitis; XS, xerostomia; XF, xerophthalmia; LN, lymph node; LUQ, left upper quadrant; RML, right middle lobe; RLL, right lower lobe; and EGD, esophagogastroduodenoscopy.</span></div><div style='clear:both;'></div></div> </div> <div class="html-table-wrap" id="rheumato-04-00012-t002"> <div class="html-table_wrap_td"> <div class="html-tablepopup html-tablepopup-link" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href='#table_body_display_rheumato-04-00012-t002'> <img data-lsrc="https://pub.mdpi-res.com/img/table.png" /> <a class="html-expand html-tablepopup" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href="#table_body_display_rheumato-04-00012-t002"></a> </div> </div> <div class="html-table_wrap_discription"> <b>Table 2.</b> Clinical and laboratory risk factors associated with the development of lymphoma. </div> </div> <div class="html-table_show mfp-hide " id="table_body_display_rheumato-04-00012-t002"> <div class="html-caption"><b>Table 2.</b> Clinical and laboratory risk factors associated with the development of lymphoma.</div> <table > <thead ><tr ><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' > </th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>1/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>2/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>3/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>4/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>5/M</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>6/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case<br>7/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>8/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>9/F</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case <br>10/F</th></tr></thead><tbody ><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Persistent enlargement of parotid glands</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Peripheral neuropathy</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Palpable purpura</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Splenomegaly</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >ANA positivity</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Rheumatoid factor positivity</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Lymphopenia <sup>1</sup></td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Monoclonal proteins in serum and/or urine</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Low C4</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Elevated immunoglobulins</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td></tr><tr ><td align='left' valign='middle' style='border-bottom:solid thin' class='html-align-left' >Cryoglobulinemia</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NA</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >+</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >−</td></tr></tbody> </table> <div class='html-table_foot html-p'><div class='html-p' style='text-indent:0em;'><span class='html-fn-content'><sup>1</sup> Lymphopenia was defined as an absolute lymphocyte count < 1000/mm<sup>3</sup>. + Risk factor present; − Risk factor absent; NA, data not available. ANA, anti-nuclear antibody.</span></div><div style='clear:both;'></div></div> </div> <div class="html-table-wrap" id="rheumato-04-00012-t003"> <div class="html-table_wrap_td"> <div class="html-tablepopup html-tablepopup-link" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href='#table_body_display_rheumato-04-00012-t003'> <img data-lsrc="https://pub.mdpi-res.com/img/table.png" /> <a class="html-expand html-tablepopup" data-counterslinkmanual = "https://www.mdpi.com/2674-0621/4/3/12/display" href="#table_body_display_rheumato-04-00012-t003"></a> </div> </div> <div class="html-table_wrap_discription"> <b>Table 3.</b> Classification of lymphoma, its treatment, and disease progression. </div> </div> <div class="html-table_show mfp-hide " id="table_body_display_rheumato-04-00012-t003"> <div class="html-caption"><b>Table 3.</b> Classification of lymphoma, its treatment, and disease progression.</div> <table > <thead ><tr ><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Case/Sex</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Age at Lymphoma Diagnosis</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Lymphoma Subtype</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Initial Induction Therapy</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Duration</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Response to Therapy</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Age at Relapse (Years)</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Number of Relapses/<br>Location</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Treatment at Relapse</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Response to Therapy</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Follow-Up Period (mo)</th><th align='center' valign='middle' style='border-top:solid thin;border-bottom:solid thin' class='html-align-center' >Disease Evolution</th></tr></thead><tbody ><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >42</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Rituximab</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >4 weeks</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >PR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >43</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/parotid gland and lip nodule</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Rituximab</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >202</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Free of disease</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >2/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >36</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >3000 cGY to right neck over 15 fractions</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >2 weeks</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >41, 58</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/parotid gland and 2/parotid gland</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/radiation and 2/resection of gland and rituximab</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >312</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Death unrelated to disease progression</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >3/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >74</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NSHL stage IVB</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >R-CHOP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >6 months</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >88</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/intrathoracic lymph nodes </td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Prednisone</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >PR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >264</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >On maintenance treatment</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >4/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >72</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MZL</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Surveillance</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >12</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Death unrelated to disease progression</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >5/M</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >55</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL, stage III</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CHOP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1 month</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >NR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >2</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Death by disease progression</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >6/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >59</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Rituximab</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >weeks</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >59</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >1/lacrimal</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Rituximab</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >24</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Death unrelated to disease progression</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >7/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >54</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >MALT</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Surveillance</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >165</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Free of disease</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >8/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >67</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL stage IV</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >RCHOP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >4 months</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >30</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Free of disease</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >9/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >71</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >DLBCL, stage 1AE</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >RCHOP</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >6 months</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >CR</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >21</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Death unrelated to disease progression</td></tr><tr ><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >10/F</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >65</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Pulmonary MALT lymphoma</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Surveillance</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >-</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >22</td><td align='center' valign='middle' style='border-bottom:solid thin' class='html-align-center' >Under surveillance</td></tr></tbody> </table> <div class='html-table_foot html-p'><div class='html-p' style='text-indent:0em;'><span class='html-fn-content'>MALT, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue; NSHL, nodular sclerosing Hodgkin’s lymphoma; MZL, B cell marginal zone lymphoma; DLBCL, diffuse large B-cell lymphoma; R-CHOP, rituximab + cyclophosphamide, doxorubicin, vincristine, prednisolone; CR, complete remission, NR, no response; and PR, partial remission. Follow-up period (mo) since lymphoma diagnosis.</span></div><div style='clear:both;'></div></div> </div> </section><section class='html-fn_group'><table><tr id=''><td></td><td><div class='html-p'><b>Disclaimer/Publisher’s Note:</b> The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.</div></td></tr></table></section> <section id="html-copyright"><br>© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener noreferrer">https://creativecommons.org/licenses/by/4.0/</a>).</section> </div> </div> <div class="additional-content"> <h2><a name="cite"></a>Share and Cite</h2> <div class="social-media-links" style="text-align: left;"> <a href="/cdn-cgi/l/email-protection#99a6bff8f4e9a2eaecfbf3fcfaeda4dfebf6f4bcaba9d4ddc9d0bcaad8bcaba9bcababc9ebfceafcf7edf8edf0f6f7bcabdabcaba9daf1f8ebf8faedfcebf0eaedf0faeabcaba9f8f7fdbcaba9dffcf8edecebfceabcaba9f6ffbcaba9d5e0f4e9f1f6f4f8bcaba9f0f7bcaba9f8bcaba9cbfcedebf6eae9fcfaedf0effcbcaba9daf8eafcbcaba9cafcebf0fceabcaba9f6ffbcaba9c9f8edf0fcf7edeabcaba9eef0edf1bcaba9caf3f6feebfcf7bcabafebeae8ecf6bcaadbeabcaba9ddf0eafcf8eafcbfe8ecf6eda2bff8f4e9a2fbf6fde0a4f1edede9eaa3b6b6eeeeeeb7f4fde9f0b7faf6f4b6aba0aaaca8a1adbcaad8bca9d8bca9d8c9ebfceafcf7edf8edf0f6f7bcabdabcaba9daf1f8ebf8faedfcebf0eaedf0faeabcaba9f8f7fdbcaba9dffcf8edecebfceabcaba9f6ffbcaba9d5e0f4e9f1f6f4f8bcaba9f0f7bcaba9f8bcaba9cbfcedebf6eae9fcfaedf0effcbcaba9daf8eafcbcaba9cafcebf0fceabcaba9f6ffbcaba9c9f8edf0fcf7edeabcaba9eef0edf1bcaba9caf3f6feebfcf7bcabafebeae8ecf6bcaadbeabcaba9ddf0eafcf8eafcbca9d8bca9d8d8fbeaedebf8faedbcaad8bcaba9caf3f6feebfcf7bcabafebeae8ecf6bcaadbeabcaba9ddf0eafcf8eafcbcaba9bcaba1caf3ddbcaba0bcaba9f0eabcaba9f8eaeaf6faf0f8edfcfdbcaba9eef0edf1bcaba9f8f7bcaba9f0f7faebfcf8eafcfdbcaba9ebf0eaf2bcaba9f6ffbcaba9f5e0f4e9f1f6f4f8b7bcaba9cefcbcaba9f0f7effceaedf0fef8edfcfdbcaba9edf1fcbcaba9e9ebfceff8f5fcf7fafcbcaba9f6ffbcaba9f5e0f4e9f1f6f4f8bcaba9f0f7bcaba9f8bcaba9ebfcedebf6eae9fcfaedf0effcbcaba9faf8eafcbcaba9eafcebf0fceabcaba9f6ffbcaba9e9f8edf0fcf7edeabcaba9eef0edf1bcaba9caf3ddbcaba9f8f7fdbcaba9ebfce9f6ebedfcfdbcaba9f6f7bcaba9edf1fcbcaba9faf5f0f7f0faf8f5bcaba9e9ebfceafcf7edf8edf0f6f7bcabdabcaba9edebfcf8edf4fcf7edbcabdabcaba9ebfceae9f6f7eafcbcabdabcaba9f8f7fdbcaba9f6ecedfaf6f4fcb7bcaba9d8bcaba9ebfcedebf6eae9fcfaedf0effcbcaba9ebfceff0fceebcaba9f6ffbcaba9a8aaabbcaba9e9f8edf0fcf7edeabcaba9fdf0f8fef7f6eafcfdbcaba9eef0edf1bcaba9caf3f6feebfcf7bcabafebeae8ecf6bcaadbeabcaba9ddf0eafcf8eafcbcaba9eef8eabcaba9faf6f7fdecfaedfcfdbcaba9f8edbcaba9f6ecebbcaba9f0f7eaedf0edecedf0f6f7bcaba9ffebf6f4bcaba9d3ecf7fcbcaba9aba9a9a9bcaba9edf6bcaba9d7f6effcf4fbfcebbcaba9aba9abaabcabdabcaba9f8f7fdbcaba9a8a9bcaba9faf8eafceabcaba9f6ffbcaba9f4f8f5f0fef7f8f7edbcaba9f5e0f4e9f1f6f4f8bcaba9eefcebfcbcaba9f0fdfcf7edf0fff0fcfdb7bcaba9daf5f0f7f0faf8f5bcaba9f8f7fdbcaba9fbf0f6f5f6fef0faf8f5bcaba9f4f8ebf2fcebeabcaba9f2f7f6eef7bcaba9edf6bcaba9fbfcbcaba9e9ebfcfdf0faedf6ebeabcaba9f6ffbcaba9f5e0f4e9f1f6f4f8bcabdabcaba9f8eabcaba9eefcf5f5bcaba9f8eabcaba9f5e0f4e9f1f6f4f8bcaba9faf1f8ebf8faedfcebf0eaedf0faeabcabdabcaba9eefcebfcbcaba9fce1f8f4f0f7fcfdb7bcaba9cdf1fcbcaba9f4f6eaedbcaba9faf6f4f4f6f7bcaba9e9ebfcfdf0faedf0effcbcaba9f5f8fbbcaba9fff0f7fdf0f7feeabcaba9eefcebfcbcaba9f1e0e9fcebfef8f4f4f8fef5f6fbecf5f0f7fcf4f0f8bcabdabcaba9edf1fcbcaba9ebf1fcecf4f8edf6f0fdbcaba9fff8faedf6ebbcabdabcaba9f8f7fdbcaba9f5e0f4e9f1f6e9fcf7f0f8b7bcaba9c9fcebeaf0eaedfcf7edbcaba9e9f8ebf6edf0fdbcaba9fef5f8f7fdbcaba9fcf7f5f8ebfefcf4fcf7edbcaba9eef8eabcaba9f8f5eaf6bcaba9fff6ecf7fdbcaba9f0f7bcaba9feebfcf8edfcebbcaba9edf1f8f7bcaba9aca9bcabacbcaba9f6ffbcaba9e9f8edf0fcf7edeab7bcaba9cdf1fcbcaba9f4f8f3f6ebf0ede0bcaba9f6ffbcaba9e9f8edf0fcf7edeabcaba9eefcebfcbcaba9daf8ecfaf8eaf0f8f7bcaba9fffcf4f8f5fceabcabdabcaba9f8f7fdbcaba9edf1fcbcaba9f8effcebf8fefcbcaba9edf0f4fcbcaba9fbfcedeefcfcf7bcaba9edf1fcbcaba9fdf0f8fef7f6eaf0eabcaba9f6ffbcaba9caf3ddbcaba9f8f7fdbcaba9f5e0f4e9f1f6f4f8bcaba9eef8eabcaba9a8adb7aabcaba9e0fcf8ebeab7bcaba9cdf1fcbcaba9f4fcfdf0f8f7bcaba9f8fefcbcaba9f8edbcaba9f5e0f4e9f1f6f4f8bcaba9fdf0f8fef7f6eaf0eabcaba9eef8eabcaba9aca0b7acbcaba9e0fcf8ebeabcabdabcaba9eef0edf1bcaba9a0bcaba9f6ecedbcaba9f6ffbcaba9a8a9bcaba9f5e0f4e9f1f6f4f8eabcaba9f0fdfcf7edf0fff0fcfdbcaba9f8eabcaba9f7f6f7b4d1f6fdfef2f0f7bcaba9f5e0f4e9f1f6f4f8bcabdabcaba9edf1fcbcaba9f4f8f3f6ebf0ede0bcaba9f6ffbcaba9faf8eafceabcaba9fbfcf0f7febcaba9f4ecfaf6eaf8b4f8eaeaf6faf0f8edfcfdbcaba9f5e0f4e9f1f6f0fdbcaba9edf0eaeaecfcbcaba9bcaba1d4d8d5cdbcaba0bcaba9f5e0f4e9f1f6f4f8b7bcaba9cefcbcaba9f0fdfcf7edf0fff0fcfdbcaba9eaf0f4f0f5f8ebf0edf0fceabcaba9f0f7bcaba9f6ecebbcaba9eafcebf0fceabcabdabcaba9eaecfaf1bcaba9f8eac2b7b7b7c4" title="Email"> <i class="fa fa-envelope-square" style="font-size: 30px;"></i> </a> <a href="https://twitter.com/intent/tweet?text=Presentation%2C+Characteristics+and+Features+of+Lymphoma+in+a+Retrospective+Case+Series+of+Patients+with+Sjogren%E2%80%99s+Disease&hashtags=mdpirheumato&url=https%3A%2F%2Fwww.mdpi.com%2F2935184&via=MDPIOpenAccess" onclick="windowOpen(this.href,600,800); return false" target="_blank" rel="noopener noreferrer"> <i class="fa fa-twitter-x-square" style="font-size: 30px;"></i> </a> <a href=" http://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fwww.mdpi.com%2F2935184&title=Presentation%2C%20Characteristics%20and%20Features%20of%20Lymphoma%20in%20a%20Retrospective%20Case%20Series%20of%20Patients%20with%20Sjogren%E2%80%99s%20Disease%26source%3Dhttps%3A%2F%2Fwww.mdpi.com%26summary%3DSjogren%E2%80%99s%20Disease%20%28SjD%29%20is%20associated%20with%20an%20increased%20risk%20of%20lymphoma.%20We%20investigated%20the%20prevalence%20of%20lymphoma%20in%20a%20retrospective%20case%20series%20of%20patients%20with%20SjD%20and%20reported%20on%20the%20clinical%20presentation%2C%20treatment%2C%20response%2C%20and%20outcome.%20A%20%5B...%5D" onclick="windowOpen(this.href,600,800); return false" title="LinkedIn" target="_blank" rel="noopener noreferrer"> <i class="fa fa-linkedin-square" style="font-size: 30px;"></i> </a> <a href="https://www.facebook.com/sharer.php?u=https://www.mdpi.com/2935184" title="facebook" target="_blank" rel="noopener noreferrer"> <i class="fa fa-facebook-square" style="font-size: 30px;"></i> </a> <a href="javascript:void(0);" title="Wechat" data-reveal-id="weixin-share-modal"> <i class="fa fa-weixin-square" style="font-size: 26px;"></i> </a> <a href="http://www.reddit.com/submit?url=https://www.mdpi.com/2935184" title="Reddit" target="_blank" rel="noopener noreferrer"> <i class="fa fa-reddit-square" style="font-size: 30px;"></i> </a> <a href="http://www.mendeley.com/import/?url=https://www.mdpi.com/2935184" title="Mendeley" target="_blank" rel="noopener noreferrer"> <i class="fa fa-mendeley-square" style="font-size: 30px;"></i> </a> </div> <div class="in-tab" style="padding-top: 0px!important; margin-top: 15px;"> <div><b>MDPI and ACS Style</b></div> <p> Behbodikhah, J.; Balistreri, L.; Carsons, S.E. Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em> <b>2024</b>, <em>4</em>, 153-162. https://doi.org/10.3390/rheumato4030012 </p> <div style="display: block"> <b>AMA Style</b><br> <p> Behbodikhah J, Balistreri L, Carsons SE. Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em>. 2024; 4(3):153-162. https://doi.org/10.3390/rheumato4030012 </p> <b>Chicago/Turabian Style</b><br> <p> Behbodikhah, Jennifer, Lisa Balistreri, and Steven E. Carsons. 2024. "Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease" <em>Rheumato</em> 4, no. 3: 153-162. https://doi.org/10.3390/rheumato4030012 </p> <b>APA Style</b><br> <p> Behbodikhah, J., Balistreri, L., & Carsons, S. E. (2024). Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em>, <em>4</em>(3), 153-162. https://doi.org/10.3390/rheumato4030012 </p> </div> </div> <h2><a name="metrics"></a>Article Metrics</h2> <div class="row"> <div class="small-12 columns"> <div id="loaded_cite_count" style="display:none">No</div> <div id="framed_div_cited_count" class="in-tab" style="display: none; overflow: auto;"></div> <div id="loaded" style="display:none">No</div> <div id="framed_div" class="in-tab" style="display: none; margin-top: 10px;"></div> </div> <div class="small-12 columns"> <div id="article_stats_div" style="display: none; margin-bottom: 1em;"> <h3>Article Access Statistics</h3> <div id="article_stats_swf" ></div> <div class="info-box"> Multiple requests from the same IP address are counted as one view. </div> </div> </div> </div> </div> </div> </article> </div> </div></div> <div class="webpymol-controls webpymol-controls-template" style="margin-top: 10px; display: none;"> <a class="bzoom">Zoom</a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="borient"> Orient </a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="blines"> As Lines </a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="bsticks"> As Sticks </a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="bcartoon"> As Cartoon </a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="bsurface"> As Surface </a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="bprevscene">Previous Scene</a> <span style="display: inline-block; margin-left: 5px; margin-right: 5px;">|</span> <a class="bnextscene">Next Scene</a> </div> <div id="scifeed-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog"> </div> <div id="recommended-articles-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog"> </div> <div id="author-biographies-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog"> </div> <div id="cite-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="Captcha" aria-hidden="true" role="dialog"> <div class="row"> <div class="small-12 columns"> <h2 style="margin: 0;">Cite</h2> </div> <div class="small-12 columns">  <form style="margin:0; padding:0; display:inline;" name="export-bibtex" method="POST" action="/export"> <input type="hidden" name="articles_ids[]" value="1467592"> <input type="hidden" name="export_format_top" value="bibtex"> <input type="hidden" name="export_submit_top" value=""> </form>  <form style="margin:0; padding:0; display:inline;" name="export-endnote" method="POST" action="/export"> <input type="hidden" name="articles_ids[]" value="1467592"> <input type="hidden" name="export_format_top" value="endnote_no_abstract"> <input type="hidden" name="export_submit_top" value=""> </form>  <form style="margin:0; padding:0; display:inline;" name="export-ris" method="POST" action="/export"> <input type="hidden" name="articles_ids[]" value="1467592"> <input type="hidden" name="export_format_top" value="ris"> <input type="hidden" name="export_submit_top" value=""> </form> <div> Export citation file: <a href="javascript:window.document.forms['export-bibtex'].submit()">BibTeX</a> | <a href="javascript:window.document.forms['export-endnote'].submit()">EndNote</a> | <a href="javascript:window.document.forms['export-ris'].submit()">RIS</a> </div> </div> <div class="small-12 columns"> <div class="in-tab"> <div><b>MDPI and ACS Style</b></div> <p> Behbodikhah, J.; Balistreri, L.; Carsons, S.E. Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em> <b>2024</b>, <em>4</em>, 153-162. https://doi.org/10.3390/rheumato4030012 </p> <div style="display: block"> <b>AMA Style</b><br> <p> Behbodikhah J, Balistreri L, Carsons SE. Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em>. 2024; 4(3):153-162. https://doi.org/10.3390/rheumato4030012 </p> <b>Chicago/Turabian Style</b><br> <p> Behbodikhah, Jennifer, Lisa Balistreri, and Steven E. Carsons. 2024. "Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease" <em>Rheumato</em> 4, no. 3: 153-162. https://doi.org/10.3390/rheumato4030012 </p> <b>APA Style</b><br> <p> Behbodikhah, J., Balistreri, L., & Carsons, S. E. (2024). Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease. <em>Rheumato</em>, <em>4</em>(3), 153-162. https://doi.org/10.3390/rheumato4030012 </p> </div> </div> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> </div> </div> </div> </div> </section> <div id="footer"> <div class="journal-info"> <span> <em><a class="Var_JournalInfo" href="/journal/rheumato">Rheumato</a></em>, EISSN 2674-0621, Published by MDPI </span> <div class="large-right"> <span> <a href="/rss/journal/rheumato" class="rss-link">RSS</a> </span> <span> <a href="/journal/rheumato/toc-alert">Content Alert</a> </span> </div> </div> <div class="row full-width footer-links" data-equalizer="footer" data-equalizer-mq="small"> <div class="large-2 large-push-4 medium-3 small-6 columns" data-equalizer-watch="footer"> <h3> Further Information </h3> <a href="/apc"> Article Processing Charges </a> <a href="/about/payment"> Pay an Invoice </a> <a href="/openaccess"> Open Access Policy </a> <a href="/about/contact"> Contact MDPI </a> <a href="https://careers.mdpi.com" target="_blank" rel="noopener noreferrer"> Jobs at MDPI </a> </div> <div class="large-2 large-push-4 medium-3 small-6 columns" data-equalizer-watch="footer"> <h3> Guidelines </h3> <a href="/authors"> For Authors </a> <a href="/reviewers"> For Reviewers </a> <a href="/editors"> For Editors </a> <a href="/librarians"> For Librarians </a> <a href="/publishing_services"> For Publishers </a> <a href="/societies"> For Societies </a> <a href="/conference_organizers"> For Conference Organizers </a> </div> <div class="large-2 large-push-4 medium-3 small-6 columns"> <h3> MDPI Initiatives </h3> <a href="https://sciforum.net" target="_blank" rel="noopener noreferrer"> Sciforum </a> <a href="https://www.mdpi.com/books" target="_blank" rel="noopener noreferrer"> MDPI Books </a> <a href="https://www.preprints.org" target="_blank" rel="noopener noreferrer"> Preprints.org </a> <a href="https://www.scilit.net" target="_blank" rel="noopener noreferrer"> Scilit </a> <a href="https://sciprofiles.com?utm_source=mpdi.com&utm_medium=bottom_menu&utm_campaign=initiative" target="_blank" rel="noopener noreferrer"> SciProfiles </a> <a href="https://encyclopedia.pub" target="_blank" rel="noopener noreferrer"> Encyclopedia </a> <a href="https://jams.pub" target="_blank" rel="noopener noreferrer"> JAMS </a> <a href="/about/proceedings"> Proceedings Series </a> </div> <div class="large-2 large-push-4 medium-3 small-6 right-border-large-without columns UA_FooterFollowMDPI"> <h3> Follow MDPI </h3> <a href="https://www.linkedin.com/company/mdpi" target="_blank" rel="noopener noreferrer"> LinkedIn </a> <a href="https://www.facebook.com/MDPIOpenAccessPublishing" target="_blank" rel="noopener noreferrer"> Facebook </a> <a href="https://twitter.com/MDPIOpenAccess" target="_blank" rel="noopener noreferrer"> Twitter </a> </div> <div id="footer-subscribe" class="large-4 large-pull-8 medium-12 small-12 left-border-large columns"> <div class="footer-subscribe__container"> <img class="show-for-large-up" src="https://pub.mdpi-res.com/img/design/mdpi-pub-logo-white-small.png?71d18e5f805839ab?1733310352" alt="MDPI" title="MDPI Open Access Journals" style="height: 50px; margin-bottom: 10px;"> <form id="newsletter" method="POST" action="/subscribe"> <p> Subscribe to receive issue release notifications and newsletters from MDPI journals </p> <select multiple id="newsletter-journal" class="foundation-select" name="journals[]"> <option value="acoustics">Acoustics</option> <option value="amh">Acta Microbiologica Hellenica</option> <option value="actuators">Actuators</option> <option value="admsci">Administrative Sciences</option> <option value="adolescents">Adolescents</option> <option value="arm">Advances in Respiratory Medicine</option> <option value="aerobiology">Aerobiology</option> <option value="aerospace">Aerospace</option> <option value="agriculture">Agriculture</option> <option value="agriengineering">AgriEngineering</option> <option value="agrochemicals">Agrochemicals</option> <option value="agronomy">Agronomy</option> <option value="ai">AI</option> <option value="air">Air</option> <option value="algorithms">Algorithms</option> <option value="allergies">Allergies</option> <option value="alloys">Alloys</option> <option value="analytica">Analytica</option> <option value="analytics">Analytics</option> <option value="anatomia">Anatomia</option> <option value="anesthres">Anesthesia Research</option> <option value="animals">Animals</option> <option value="antibiotics">Antibiotics</option> <option value="antibodies">Antibodies</option> <option value="antioxidants">Antioxidants</option> <option value="applbiosci">Applied Biosciences</option> <option value="applmech">Applied Mechanics</option> <option value="applmicrobiol">Applied Microbiology</option> <option value="applnano">Applied Nano</option> <option value="applsci">Applied Sciences</option> <option value="asi">Applied System Innovation</option> <option value="appliedchem">AppliedChem</option> <option value="appliedmath">AppliedMath</option> <option value="aquacj">Aquaculture Journal</option> <option value="architecture">Architecture</option> <option value="arthropoda">Arthropoda</option> <option value="arts">Arts</option> <option value="astronomy">Astronomy</option> <option value="atmosphere">Atmosphere</option> <option value="atoms">Atoms</option> <option value="audiolres">Audiology Research</option> <option value="automation">Automation</option> <option value="axioms">Axioms</option> <option value="bacteria">Bacteria</option> <option value="batteries">Batteries</option> <option value="behavsci">Behavioral Sciences</option> <option value="beverages">Beverages</option> <option value="BDCC">Big Data and Cognitive Computing</option> <option value="biochem">BioChem</option> <option value="bioengineering">Bioengineering</option> <option value="biologics">Biologics</option> <option value="biology">Biology</option> <option value="blsf">Biology and Life Sciences Forum</option> <option value="biomass">Biomass</option> <option value="biomechanics">Biomechanics</option> <option value="biomed">BioMed</option> <option value="biomedicines">Biomedicines</option> <option value="biomedinformatics">BioMedInformatics</option> <option value="biomimetics">Biomimetics</option> <option value="biomolecules">Biomolecules</option> <option value="biophysica">Biophysica</option> <option value="biosensors">Biosensors</option> <option value="biotech">BioTech</option> <option value="birds">Birds</option> <option value="blockchains">Blockchains</option> <option value="brainsci">Brain Sciences</option> <option value="buildings">Buildings</option> <option value="businesses">Businesses</option> <option value="carbon">C</option> <option value="cancers">Cancers</option> <option value="cardiogenetics">Cardiogenetics</option> <option value="catalysts">Catalysts</option> <option value="cells">Cells</option> <option value="ceramics">Ceramics</option> <option value="challenges">Challenges</option> <option value="ChemEngineering">ChemEngineering</option> <option value="chemistry">Chemistry</option> <option value="chemproc">Chemistry Proceedings</option> <option value="chemosensors">Chemosensors</option> <option value="children">Children</option> <option value="chips">Chips</option> <option value="civileng">CivilEng</option> <option value="cleantechnol">Clean Technologies</option> <option value="climate">Climate</option> <option value="ctn">Clinical and Translational Neuroscience</option> <option value="clinbioenerg">Clinical Bioenergetics</option> <option value="clinpract">Clinics and Practice</option> <option value="clockssleep">Clocks & Sleep</option> <option value="coasts">Coasts</option> <option value="coatings">Coatings</option> <option value="colloids">Colloids and Interfaces</option> <option value="colorants">Colorants</option> <option value="commodities">Commodities</option> <option value="complications">Complications</option> <option value="compounds">Compounds</option> <option value="computation">Computation</option> <option value="csmf">Computer Sciences & Mathematics Forum</option> <option value="computers">Computers</option> <option value="condensedmatter">Condensed Matter</option> <option value="conservation">Conservation</option> <option value="constrmater">Construction Materials</option> <option value="cmd">Corrosion and Materials Degradation</option> <option value="cosmetics">Cosmetics</option> <option value="covid">COVID</option> <option value="crops">Crops</option> <option value="cryo">Cryo</option> <option value="cryptography">Cryptography</option> <option value="crystals">Crystals</option> <option value="cimb">Current Issues in Molecular Biology</option> <option value="curroncol">Current Oncology</option> <option value="dairy">Dairy</option> <option value="data">Data</option> <option value="dentistry">Dentistry Journal</option> <option value="dermato">Dermato</option> <option value="dermatopathology">Dermatopathology</option> <option value="designs">Designs</option> <option value="diabetology">Diabetology</option> <option value="diagnostics">Diagnostics</option> <option value="dietetics">Dietetics</option> <option value="digital">Digital</option> <option value="disabilities">Disabilities</option> <option value="diseases">Diseases</option> <option value="diversity">Diversity</option> <option value="dna">DNA</option> <option value="drones">Drones</option> <option value="ddc">Drugs and Drug Candidates</option> <option value="dynamics">Dynamics</option> <option value="earth">Earth</option> <option value="ecologies">Ecologies</option> <option value="econometrics">Econometrics</option> <option value="economies">Economies</option> <option value="education">Education Sciences</option> <option value="electricity">Electricity</option> <option value="electrochem">Electrochem</option> <option value="electronicmat">Electronic Materials</option> <option value="electronics">Electronics</option> <option value="ecm">Emergency Care and Medicine</option> <option value="encyclopedia">Encyclopedia</option> <option value="endocrines">Endocrines</option> <option value="energies">Energies</option> <option value="esa">Energy Storage and Applications</option> <option value="eng">Eng</option> <option value="engproc">Engineering Proceedings</option> <option value="entropy">Entropy</option> <option value="eesp">Environmental and Earth Sciences Proceedings</option> <option value="environments">Environments</option> <option value="epidemiologia">Epidemiologia</option> <option value="epigenomes">Epigenomes</option> <option value="ebj">European Burn Journal</option> <option value="ejihpe">European Journal of Investigation in Health, Psychology and Education</option> <option value="fermentation">Fermentation</option> <option value="fibers">Fibers</option> <option value="fintech">FinTech</option> <option value="fire">Fire</option> <option value="fishes">Fishes</option> <option value="fluids">Fluids</option> <option value="foods">Foods</option> <option value="forecasting">Forecasting</option> <option value="forensicsci">Forensic Sciences</option> <option value="forests">Forests</option> <option value="fossstud">Fossil Studies</option> <option value="foundations">Foundations</option> <option value="fractalfract">Fractal and Fractional</option> <option value="fuels">Fuels</option> <option value="future">Future</option> <option value="futureinternet">Future Internet</option> <option value="futurepharmacol">Future Pharmacology</option> <option value="futuretransp">Future Transportation</option> <option value="galaxies">Galaxies</option> <option value="games">Games</option> <option value="gases">Gases</option> <option value="gastroent">Gastroenterology Insights</option> <option value="gastrointestdisord">Gastrointestinal Disorders</option> <option value="gastronomy">Gastronomy</option> <option value="gels">Gels</option> <option value="genealogy">Genealogy</option> <option value="genes">Genes</option> <option value="geographies">Geographies</option> <option value="geohazards">GeoHazards</option> <option value="geomatics">Geomatics</option> <option value="geometry">Geometry</option> <option value="geosciences">Geosciences</option> <option value="geotechnics">Geotechnics</option> <option value="geriatrics">Geriatrics</option> <option value="glacies">Glacies</option> <option value="gucdd">Gout, Urate, and Crystal Deposition Disease</option> <option value="grasses">Grasses</option> <option value="hardware">Hardware</option> <option value="healthcare">Healthcare</option> <option value="hearts">Hearts</option> <option value="hemato">Hemato</option> <option value="hematolrep">Hematology Reports</option> <option value="heritage">Heritage</option> <option value="histories">Histories</option> <option value="horticulturae">Horticulturae</option> <option value="hospitals">Hospitals</option> <option value="humanities">Humanities</option> <option value="humans">Humans</option> <option value="hydrobiology">Hydrobiology</option> <option value="hydrogen">Hydrogen</option> <option value="hydrology">Hydrology</option> <option value="hygiene">Hygiene</option> <option value="immuno">Immuno</option> <option value="idr">Infectious Disease Reports</option> <option value="informatics">Informatics</option> <option value="information">Information</option> <option value="infrastructures">Infrastructures</option> <option value="inorganics">Inorganics</option> <option value="insects">Insects</option> <option value="instruments">Instruments</option> <option value="iic">Intelligent Infrastructure and Construction</option> <option value="ijerph">International Journal of Environmental Research and Public Health</option> <option value="ijfs">International Journal of Financial Studies</option> <option value="ijms">International Journal of Molecular Sciences</option> <option value="IJNS">International Journal of Neonatal Screening</option> <option value="ijpb">International Journal of Plant Biology</option> <option value="ijt">International Journal of Topology</option> <option value="ijtm">International Journal of Translational Medicine</option> <option value="ijtpp">International Journal of Turbomachinery, Propulsion and Power</option> <option value="ime">International Medical Education</option> <option value="inventions">Inventions</option> <option value="IoT">IoT</option> <option value="ijgi">ISPRS International Journal of Geo-Information</option> <option value="J">J</option> <option value="jal">Journal of Ageing and Longevity</option> <option value="jcdd">Journal of Cardiovascular Development and Disease</option> <option value="jcto">Journal of Clinical & Translational Ophthalmology</option> <option value="jcm">Journal of Clinical Medicine</option> <option value="jcs">Journal of Composites Science</option> <option value="jcp">Journal of Cybersecurity and Privacy</option> <option value="jdad">Journal of Dementia and Alzheimer's Disease</option> <option value="jdb">Journal of Developmental Biology</option> <option value="jeta">Journal of Experimental and Theoretical Analyses</option> <option value="jfb">Journal of Functional Biomaterials</option> <option value="jfmk">Journal of Functional Morphology and Kinesiology</option> <option value="jof">Journal of Fungi</option> <option value="jimaging">Journal of Imaging</option> <option value="jintelligence">Journal of Intelligence</option> <option value="jlpea">Journal of Low Power Electronics and Applications</option> <option value="jmmp">Journal of Manufacturing and Materials Processing</option> <option value="jmse">Journal of Marine Science and Engineering</option> <option value="jmahp">Journal of Market Access & Health Policy</option> <option value="jmp">Journal of Molecular Pathology</option> <option value="jnt">Journal of Nanotheranostics</option> <option value="jne">Journal of Nuclear Engineering</option> <option value="ohbm">Journal of Otorhinolaryngology, Hearing and Balance Medicine</option> <option value="jop">Journal of Parks</option> <option value="jpm">Journal of Personalized Medicine</option> <option value="jpbi">Journal of Pharmaceutical and BioTech Industry</option> <option value="jor">Journal of Respiration</option> <option value="jrfm">Journal of Risk and Financial Management</option> <option value="jsan">Journal of Sensor and Actuator Networks</option> <option value="joma">Journal of the Oman Medical Association</option> <option value="jtaer">Journal of Theoretical and Applied Electronic Commerce Research</option> <option value="jvd">Journal of Vascular Diseases</option> <option value="jox">Journal of Xenobiotics</option> <option value="jzbg">Journal of Zoological and Botanical Gardens</option> <option value="journalmedia">Journalism and Media</option> <option value="kidneydial">Kidney and Dialysis</option> <option value="kinasesphosphatases">Kinases and Phosphatases</option> <option value="knowledge">Knowledge</option> <option value="labmed">LabMed</option> <option value="laboratories">Laboratories</option> <option value="land">Land</option> <option value="languages">Languages</option> <option value="laws">Laws</option> <option value="life">Life</option> <option value="limnolrev">Limnological Review</option> <option value="lipidology">Lipidology</option> <option value="liquids">Liquids</option> <option value="literature">Literature</option> <option value="livers">Livers</option> <option value="logics">Logics</option> <option value="logistics">Logistics</option> <option value="lubricants">Lubricants</option> <option value="lymphatics">Lymphatics</option> <option value="make">Machine Learning and Knowledge Extraction</option> <option value="machines">Machines</option> <option value="macromol">Macromol</option> <option value="magnetism">Magnetism</option> <option value="magnetochemistry">Magnetochemistry</option> <option value="marinedrugs">Marine Drugs</option> <option value="materials">Materials</option> <option value="materproc">Materials Proceedings</option> <option value="mca">Mathematical and Computational Applications</option> <option value="mathematics">Mathematics</option> <option value="medsci">Medical Sciences</option> <option value="msf">Medical Sciences Forum</option> <option value="medicina">Medicina</option> <option value="medicines">Medicines</option> <option value="membranes">Membranes</option> <option value="merits">Merits</option> <option value="metabolites">Metabolites</option> <option value="metals">Metals</option> <option value="meteorology">Meteorology</option> <option value="methane">Methane</option> <option value="mps">Methods and Protocols</option> <option value="metrics">Metrics</option> <option value="metrology">Metrology</option> <option value="micro">Micro</option> <option value="microbiolres">Microbiology Research</option> <option value="micromachines">Micromachines</option> <option value="microorganisms">Microorganisms</option> <option value="microplastics">Microplastics</option> <option value="minerals">Minerals</option> <option value="mining">Mining</option> <option value="modelling">Modelling</option> <option value="mmphys">Modern Mathematical Physics</option> <option value="molbank">Molbank</option> <option value="molecules">Molecules</option> <option value="mti">Multimodal Technologies and Interaction</option> <option value="muscles">Muscles</option> <option value="nanoenergyadv">Nanoenergy Advances</option> <option value="nanomanufacturing">Nanomanufacturing</option> <option value="nanomaterials">Nanomaterials</option> <option value="ndt">NDT</option> <option value="network">Network</option> <option value="neuroglia">Neuroglia</option> <option value="neurolint">Neurology International</option> <option value="neurosci">NeuroSci</option> <option value="nitrogen">Nitrogen</option> <option value="ncrna">Non-Coding RNA</option> <option value="nursrep">Nursing Reports</option> <option value="nutraceuticals">Nutraceuticals</option> <option value="nutrients">Nutrients</option> <option value="obesities">Obesities</option> <option value="oceans">Oceans</option> <option value="onco">Onco</option> <option value="optics">Optics</option> <option value="oral">Oral</option> <option value="organics">Organics</option> <option value="organoids">Organoids</option> <option value="osteology">Osteology</option> <option value="oxygen">Oxygen</option> <option value="parasitologia">Parasitologia</option> <option value="particles">Particles</option> <option value="pathogens">Pathogens</option> <option value="pathophysiology">Pathophysiology</option> <option value="pediatrrep">Pediatric Reports</option> <option value="pets">Pets</option> <option value="pharmaceuticals">Pharmaceuticals</option> <option value="pharmaceutics">Pharmaceutics</option> <option value="pharmacoepidemiology">Pharmacoepidemiology</option> <option value="pharmacy">Pharmacy</option> <option value="philosophies">Philosophies</option> <option value="photochem">Photochem</option> <option value="photonics">Photonics</option> <option value="phycology">Phycology</option> <option value="physchem">Physchem</option> <option value="psf">Physical Sciences Forum</option> <option value="physics">Physics</option> <option value="physiologia">Physiologia</option> <option value="plants">Plants</option> <option value="plasma">Plasma</option> <option value="platforms">Platforms</option> <option value="pollutants">Pollutants</option> <option value="polymers">Polymers</option> <option value="polysaccharides">Polysaccharides</option> <option value="populations">Populations</option> <option value="poultry">Poultry</option> <option value="powders">Powders</option> <option value="proceedings">Proceedings</option> <option value="processes">Processes</option> <option value="prosthesis">Prosthesis</option> <option value="proteomes">Proteomes</option> <option value="psychiatryint">Psychiatry International</option> <option value="psychoactives">Psychoactives</option> <option value="psycholint">Psychology International</option> <option value="publications">Publications</option> <option value="qubs">Quantum Beam Science</option> <option value="quantumrep">Quantum Reports</option> <option value="quaternary">Quaternary</option> <option value="radiation">Radiation</option> <option value="reactions">Reactions</option> <option value="realestate">Real Estate</option> <option value="receptors">Receptors</option> <option value="recycling">Recycling</option> <option value="rsee">Regional Science and Environmental Economics</option> <option value="religions">Religions</option> <option value="remotesensing">Remote Sensing</option> <option value="reports">Reports</option> <option value="reprodmed">Reproductive Medicine</option> <option value="resources">Resources</option> <option value="rheumato">Rheumato</option> <option value="risks">Risks</option> <option value="robotics">Robotics</option> <option value="ruminants">Ruminants</option> <option value="safety">Safety</option> <option value="sci">Sci</option> <option value="scipharm">Scientia Pharmaceutica</option> <option value="sclerosis">Sclerosis</option> <option value="seeds">Seeds</option> <option value="sensors">Sensors</option> <option value="separations">Separations</option> <option value="sexes">Sexes</option> <option value="signals">Signals</option> <option value="sinusitis">Sinusitis</option> <option value="smartcities">Smart Cities</option> <option value="socsci">Social Sciences</option> <option value="siuj">Société Internationale d’Urologie Journal</option> <option value="societies">Societies</option> <option value="software">Software</option> <option value="soilsystems">Soil Systems</option> <option value="solar">Solar</option> <option value="solids">Solids</option> <option value="spectroscj">Spectroscopy Journal</option> <option value="sports">Sports</option> <option value="standards">Standards</option> <option value="stats">Stats</option> <option value="stresses">Stresses</option> <option value="surfaces">Surfaces</option> <option value="surgeries">Surgeries</option> <option value="std">Surgical Techniques Development</option> <option value="sustainability">Sustainability</option> <option value="suschem">Sustainable Chemistry</option> <option value="symmetry">Symmetry</option> <option value="synbio">SynBio</option> <option value="systems">Systems</option> <option value="targets">Targets</option> <option value="taxonomy">Taxonomy</option> <option value="technologies">Technologies</option> <option value="telecom">Telecom</option> <option value="textiles">Textiles</option> <option value="thalassrep">Thalassemia Reports</option> <option value="therapeutics">Therapeutics</option> <option value="thermo">Thermo</option> <option value="timespace">Time and Space</option> <option value="tomography">Tomography</option> <option value="tourismhosp">Tourism and Hospitality</option> <option value="toxics">Toxics</option> <option value="toxins">Toxins</option> <option value="transplantology">Transplantology</option> <option value="traumacare">Trauma Care</option> <option value="higheredu">Trends in Higher Education</option> <option value="tropicalmed">Tropical Medicine and Infectious Disease</option> <option value="universe">Universe</option> <option value="urbansci">Urban Science</option> <option value="uro">Uro</option> <option value="vaccines">Vaccines</option> <option value="vehicles">Vehicles</option> <option value="venereology">Venereology</option> <option value="vetsci">Veterinary Sciences</option> <option value="vibration">Vibration</option> <option value="virtualworlds">Virtual Worlds</option> <option value="viruses">Viruses</option> <option value="vision">Vision</option> <option value="waste">Waste</option> <option value="water">Water</option> <option value="wild">Wild</option> <option value="wind">Wind</option> <option value="women">Women</option> <option value="world">World</option> <option value="wevj">World Electric Vehicle Journal</option> <option value="youth">Youth</option> <option value="zoonoticdis">Zoonotic Diseases</option> </select> <input name="email" type="email" placeholder="Enter your email address..." required="required" /> <button class="genericCaptcha button button--dark UA_FooterNewsletterSubscribeButton" type="submit">Subscribe</button> </form> </div> </div> </div> <div id="footer-copyright"> <div class="row"> <div class="columns large-6 medium-6 small-12 text-left"> © 1996-2024 MDPI (Basel, Switzerland) unless otherwise stated </div> <div class="columns large-6 medium-6 small-12 small-text-left medium-text-right large-text-right"> <a data-dropdown="drop-view-disclaimer" aria-controls="drop-view-disclaimer" aria-expanded="false" data-options="align:top; is_hover:true; hover_timeout:2000;"> Disclaimer </a> <div id="drop-view-disclaimer" class="f-dropdown label__btn__dropdown label__btn__dropdown--wide text-left" data-dropdown-content aria-hidden="true" tabindex="-1"> Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. </div> <a href="/about/terms-and-conditions"> Terms and Conditions </a> <a href="/about/privacy"> Privacy Policy </a> </div> </div> </div> </div> <div id="cookie-notification" class="js-allow-cookies" style="display: none;"> <div class="columns large-10 medium-10 small-12"> We use cookies on our website to ensure you get the best experience.<br class="show-for-medium-up"/> Read more about our cookies <a href="/about/privacy">here</a>. </div> <div class="columns large-2 medium-2 small-12 small-only-text-left text-right"> <a class="button button--default" href="/accept_cookies">Accept</a> </div> </div> </div> <div id="main-share-modal" class="reveal-modal reveal-modal-new reveal-modal-new--small" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog"> <div class="row"> <div class="small-12 columns"> <h2 style="margin: 0;">Share Link</h2> </div> <div class="small-12 columns"> <div class="social-media-links UA_ShareModalLinks" style="text-align: left;"> <a href="/cdn-cgi/l/email-protection#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" title="Email"> <i class="fa fa-envelope-square" style="font-size: 30px;"></i> </a> <a href="https://twitter.com/intent/tweet?text=Presentation%2C+Characteristics+and+Features+of+Lymphoma+in+a+Retrospective+Case+Series+of+Patients+with+Sjogren%E2%80%99s+Disease&hashtags=mdpirheumato&url=https%3A%2F%2Fwww.mdpi.com%2F2935184&via=MDPIOpenAccess" onclick="windowOpen(this.href,600,800); return false" title="Twitter" target="_blank" rel="noopener noreferrer"> <i class="fa fa-twitter-x-square" style="font-size: 30px;"></i> </a> <a href=" http://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fwww.mdpi.com%2F2935184&title=Presentation%2C%20Characteristics%20and%20Features%20of%20Lymphoma%20in%20a%20Retrospective%20Case%20Series%20of%20Patients%20with%20Sjogren%E2%80%99s%20Disease%26source%3Dhttps%3A%2F%2Fwww.mdpi.com%26summary%3DSjogren%E2%80%99s%20Disease%20%28SjD%29%20is%20associated%20with%20an%20increased%20risk%20of%20lymphoma.%20We%20investigated%20the%20prevalence%20of%20lymphoma%20in%20a%20retrospective%20case%20series%20of%20patients%20with%20SjD%20and%20reported%20on%20the%20clinical%20presentation%2C%20treatment%2C%20response%2C%20and%20outcome.%20A%20%5B...%5D" onclick="windowOpen(this.href,600,800); return false" title="LinkedIn" target="_blank" rel="noopener noreferrer"> <i class="fa fa-linkedin-square" style="font-size: 30px;"></i> </a> <a href="https://www.facebook.com/sharer.php?u=https://www.mdpi.com/2935184" title="facebook" target="_blank" rel="noopener noreferrer"> <i class="fa fa-facebook-square" style="font-size: 30px;"></i> </a> <a href="javascript:void(0);" title="Wechat" data-reveal-id="weixin-share-modal"> <i class="fa fa-weixin-square" style="font-size: 26px;"></i> </a> <a href="http://www.reddit.com/submit?url=https://www.mdpi.com/2935184" title="Reddit" target="_blank" rel="noopener noreferrer"> <i class="fa fa-reddit-square" style="font-size: 30px;"></i> </a> <a href="http://www.mendeley.com/import/?url=https://www.mdpi.com/2935184" title="Mendeley" target="_blank" rel="noopener noreferrer"> <i class="fa fa-mendeley-square" style="font-size: 30px;"></i> </a> <a href="http://www.citeulike.org/posturl?url=https://www.mdpi.com/2935184" title="CiteULike" target="_blank" rel="noopener noreferrer"> <i class="fa fa-citeulike-square" style="font-size: 30px;"></i> </a> </div> </div> <div class="small-9 columns"> <input id="js-clipboard-text" type="text" readonly value="https://www.mdpi.com/2935184" /> </div> <div class="small-3 columns text-left"> <a class="button button--color js-clipboard-copy" data-clipboard-target="#js-clipboard-text">Copy</a> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> <div id="weixin-share-modal" class="reveal-modal reveal-modal-new" data-reveal aria-labelledby="weixin-share-modal-title" aria-hidden="true" role="dialog"> <div class="row"> <div class="small-12 columns"> <h2 id="weixin-share-modal-title" style="margin: 0;">Share</h2> </div> <div class="small-12 columns"> <div class="weixin-qr-code-section"> <?xml version="1.0" standalone="no"?> <!DOCTYPE svg PUBLIC "-//W3C//DTD SVG 1.1//EN" "http://www.w3.org/Graphics/SVG/1.1/DTD/svg11.dtd"> <svg width="300" height="300" version="1.1" xmlns="http://www.w3.org/2000/svg"> <desc>https://www.mdpi.com/2935184</desc> <g id="elements" fill="black" stroke="none"> <rect x="0" y="0" width="12" height="12" /> <rect x="12" y="0" width="12" height="12" /> <rect x="24" y="0" width="12" height="12" /> <rect x="36" y="0" width="12" height="12" /> <rect x="48" y="0" width="12" height="12" /> <rect x="60" y="0" width="12" height="12" /> <rect x="72" y="0" width="12" height="12" /> <rect x="108" y="0" width="12" height="12" /> <rect x="192" y="0" width="12" height="12" /> <rect x="216" y="0" width="12" height="12" /> <rect x="228" y="0" width="12" height="12" /> <rect x="240" y="0" width="12" height="12" /> <rect x="252" y="0" width="12" height="12" /> <rect x="264" y="0" width="12" height="12" /> <rect x="276" y="0" width="12" height="12" /> <rect x="288" y="0" width="12" height="12" /> <rect x="0" y="12" width="12" height="12" /> <rect x="72" y="12" width="12" height="12" /> <rect x="96" y="12" width="12" height="12" /> <rect x="108" y="12" width="12" height="12" /> <rect x="132" y="12" width="12" height="12" /> <rect x="144" y="12" width="12" height="12" /> <rect x="156" y="12" width="12" height="12" /> <rect x="180" y="12" width="12" height="12" /> <rect x="216" y="12" width="12" height="12" /> <rect x="288" y="12" width="12" height="12" /> <rect x="0" y="24" width="12" height="12" /> <rect x="24" y="24" width="12" height="12" /> <rect x="36" y="24" width="12" height="12" /> <rect x="48" y="24" width="12" height="12" /> <rect x="72" y="24" width="12" height="12" /> <rect x="108" y="24" width="12" height="12" /> <rect x="120" y="24" width="12" height="12" /> <rect x="132" y="24" width="12" height="12" /> <rect x="168" y="24" width="12" height="12" /> <rect x="192" y="24" width="12" height="12" /> <rect x="216" y="24" width="12" height="12" /> <rect x="240" y="24" width="12" height="12" /> <rect x="252" y="24" width="12" height="12" /> <rect x="264" y="24" width="12" height="12" /> <rect x="288" y="24" width="12" height="12" /> <rect x="0" y="36" width="12" height="12" /> <rect x="24" y="36" width="12" height="12" /> <rect x="36" y="36" width="12" height="12" /> <rect x="48" y="36" width="12" height="12" /> <rect x="72" y="36" width="12" height="12" /> <rect x="96" y="36" width="12" height="12" /> <rect x="108" y="36" width="12" height="12" /> <rect x="132" y="36" width="12" height="12" /> <rect x="144" y="36" width="12" height="12" /> <rect x="156" y="36" width="12" height="12" /> <rect x="168" y="36" width="12" height="12" /> <rect x="216" y="36" width="12" height="12" /> <rect x="240" y="36" width="12" height="12" /> <rect x="252" y="36" width="12" height="12" /> <rect x="264" y="36" width="12" height="12" /> <rect x="288" y="36" width="12" height="12" /> <rect x="0" y="48" width="12" height="12" /> <rect x="24" y="48" width="12" height="12" /> <rect x="36" y="48" width="12" height="12" /> <rect x="48" y="48" width="12" height="12" /> <rect x="72" y="48" width="12" height="12" /> <rect x="120" y="48" width="12" height="12" /> <rect x="144" y="48" width="12" height="12" /> <rect x="156" y="48" width="12" height="12" /> <rect x="216" y="48" width="12" height="12" /> <rect x="240" y="48" width="12" height="12" /> <rect x="252" y="48" width="12" height="12" /> <rect x="264" y="48" width="12" height="12" /> <rect x="288" y="48" width="12" height="12" /> <rect x="0" y="60" width="12" height="12" /> <rect x="72" y="60" width="12" height="12" /> <rect x="96" y="60" width="12" height="12" /> <rect x="120" y="60" width="12" height="12" /> <rect x="144" y="60" width="12" height="12" /> <rect x="156" y="60" width="12" height="12" /> <rect x="168" y="60" width="12" height="12" /> <rect x="180" y="60" width="12" height="12" /> <rect x="192" y="60" width="12" height="12" /> <rect x="216" y="60" width="12" height="12" /> <rect x="288" y="60" width="12" height="12" /> <rect x="0" y="72" width="12" height="12" /> <rect x="12" y="72" width="12" height="12" /> <rect x="24" y="72" width="12" height="12" /> <rect x="36" y="72" width="12" height="12" /> <rect x="48" y="72" width="12" height="12" /> <rect x="60" y="72" width="12" height="12" /> <rect x="72" y="72" width="12" height="12" /> <rect x="96" y="72" width="12" height="12" /> <rect x="120" y="72" width="12" height="12" /> <rect x="144" y="72" width="12" height="12" /> <rect x="168" y="72" width="12" height="12" /> <rect x="192" y="72" width="12" height="12" /> <rect x="216" y="72" width="12" height="12" /> <rect x="228" y="72" width="12" height="12" /> <rect x="240" y="72" width="12" height="12" /> <rect x="252" y="72" width="12" height="12" /> <rect x="264" y="72" width="12" height="12" /> <rect x="276" y="72" width="12" height="12" /> <rect x="288" y="72" width="12" height="12" /> <rect x="144" y="84" width="12" height="12" /> <rect x="168" y="84" width="12" height="12" /> <rect x="180" y="84" width="12" height="12" /> <rect x="0" y="96" width="12" height="12" /> <rect x="12" y="96" width="12" height="12" /> <rect x="24" y="96" width="12" height="12" /> <rect x="36" y="96" width="12" height="12" /> <rect x="48" y="96" width="12" height="12" /> <rect x="72" y="96" width="12" height="12" /> <rect x="84" y="96" width="12" height="12" /> <rect x="96" y="96" width="12" height="12" /> <rect x="108" y="96" width="12" height="12" /> <rect x="120" y="96" width="12" height="12" /> <rect x="144" y="96" width="12" height="12" /> <rect x="156" y="96" width="12" height="12" /> <rect x="168" y="96" width="12" height="12" /> <rect x="204" y="96" width="12" height="12" /> <rect x="228" y="96" width="12" height="12" /> <rect x="252" y="96" width="12" height="12" /> <rect x="276" y="96" width="12" height="12" /> <rect x="12" y="108" width="12" height="12" /> <rect x="24" y="108" width="12" height="12" /> <rect x="36" y="108" width="12" height="12" /> <rect x="60" y="108" width="12" height="12" /> <rect x="96" y="108" width="12" height="12" /> <rect x="108" y="108" width="12" height="12" /> <rect x="144" y="108" width="12" height="12" /> <rect x="156" y="108" width="12" height="12" /> <rect x="192" y="108" width="12" height="12" /> <rect x="204" y="108" width="12" height="12" /> <rect x="228" y="108" width="12" height="12" /> <rect x="276" y="108" width="12" height="12" /> <rect x="24" y="120" width="12" height="12" /> <rect x="36" y="120" width="12" height="12" /> <rect x="60" y="120" width="12" height="12" /> <rect x="72" y="120" width="12" height="12" /> <rect x="84" y="120" width="12" height="12" /> <rect x="96" y="120" width="12" height="12" /> <rect x="108" y="120" width="12" height="12" /> <rect x="144" y="120" width="12" height="12" /> <rect x="168" y="120" width="12" height="12" /> <rect x="180" y="120" width="12" height="12" /> <rect x="204" y="120" width="12" height="12" /> <rect x="216" y="120" width="12" height="12" /> <rect x="228" y="120" width="12" height="12" /> <rect x="240" y="120" width="12" height="12" /> <rect x="252" y="120" width="12" height="12" /> <rect x="276" y="120" width="12" height="12" /> <rect x="288" y="120" width="12" height="12" /> <rect x="24" y="132" width="12" height="12" /> <rect x="36" y="132" width="12" height="12" /> <rect x="60" y="132" width="12" height="12" /> <rect x="108" y="132" width="12" height="12" /> <rect x="120" y="132" width="12" height="12" /> <rect x="132" y="132" width="12" height="12" /> <rect x="168" y="132" width="12" height="12" /> <rect x="180" y="132" width="12" height="12" /> <rect x="204" y="132" width="12" height="12" /> <rect x="228" y="132" width="12" height="12" /> <rect x="288" y="132" width="12" height="12" /> <rect x="0" y="144" width="12" height="12" /> <rect x="12" y="144" width="12" height="12" /> <rect x="24" y="144" width="12" height="12" /> <rect x="36" y="144" width="12" height="12" /> <rect x="48" y="144" width="12" height="12" /> <rect x="72" y="144" width="12" height="12" /> <rect x="84" y="144" width="12" height="12" /> <rect x="96" y="144" width="12" height="12" /> <rect x="108" y="144" width="12" height="12" /> <rect x="156" y="144" width="12" height="12" /> <rect x="180" y="144" width="12" height="12" /> <rect x="192" y="144" width="12" height="12" /> <rect x="204" y="144" width="12" height="12" /> <rect x="216" y="144" width="12" height="12" /> <rect x="228" y="144" width="12" height="12" /> <rect x="240" y="144" width="12" height="12" /> <rect x="264" y="144" width="12" height="12" /> <rect x="276" y="144" width="12" height="12" /> <rect x="288" y="144" width="12" height="12" /> <rect x="0" y="156" width="12" height="12" /> <rect x="24" y="156" width="12" height="12" /> <rect x="36" y="156" width="12" height="12" /> <rect x="60" y="156" width="12" height="12" /> <rect x="84" y="156" width="12" height="12" /> <rect x="108" y="156" width="12" height="12" /> <rect x="120" y="156" width="12" height="12" /> <rect x="132" y="156" width="12" height="12" /> <rect x="144" y="156" width="12" height="12" /> <rect x="192" y="156" width="12" height="12" /> <rect x="204" y="156" width="12" height="12" /> <rect x="228" y="156" width="12" height="12" /> <rect x="252" y="156" width="12" height="12" /> <rect x="276" y="156" width="12" height="12" /> <rect x="0" y="168" width="12" height="12" /> <rect x="48" y="168" width="12" height="12" /> <rect x="72" y="168" width="12" height="12" /> <rect x="108" y="168" width="12" height="12" /> <rect x="132" y="168" width="12" height="12" /> <rect x="144" y="168" width="12" height="12" /> <rect x="180" y="168" width="12" height="12" /> <rect x="204" y="168" width="12" height="12" /> <rect x="216" y="168" width="12" height="12" /> <rect x="228" y="168" width="12" height="12" /> <rect x="240" y="168" width="12" height="12" /> <rect x="252" y="168" width="12" height="12" /> <rect x="276" y="168" width="12" height="12" /> <rect x="288" y="168" width="12" height="12" /> <rect x="0" y="180" width="12" height="12" /> <rect x="48" y="180" width="12" height="12" /> <rect x="144" y="180" width="12" height="12" /> <rect x="180" y="180" width="12" height="12" /> <rect x="192" y="180" width="12" height="12" /> <rect x="204" y="180" width="12" height="12" /> <rect x="228" y="180" width="12" height="12" /> <rect x="240" y="180" width="12" height="12" /> <rect x="288" y="180" width="12" height="12" /> <rect x="0" y="192" width="12" height="12" /> <rect x="60" y="192" width="12" height="12" /> <rect x="72" y="192" width="12" height="12" /> <rect x="84" y="192" width="12" height="12" /> <rect x="132" y="192" width="12" height="12" /> <rect x="144" y="192" width="12" height="12" /> <rect x="168" y="192" width="12" height="12" /> <rect x="180" y="192" width="12" height="12" /> <rect x="192" y="192" width="12" height="12" /> <rect x="204" y="192" width="12" height="12" /> <rect x="216" y="192" width="12" height="12" /> <rect x="228" y="192" width="12" height="12" /> <rect x="240" y="192" width="12" height="12" /> <rect x="264" y="192" width="12" height="12" /> <rect x="96" y="204" width="12" height="12" /> <rect x="108" y="204" width="12" height="12" /> <rect x="144" y="204" width="12" height="12" /> <rect x="180" y="204" width="12" height="12" /> <rect x="192" y="204" width="12" height="12" /> <rect x="240" y="204" width="12" height="12" /> <rect x="252" y="204" width="12" height="12" /> <rect x="0" y="216" width="12" height="12" /> <rect x="12" y="216" width="12" height="12" /> <rect x="24" y="216" width="12" height="12" /> <rect x="36" y="216" width="12" height="12" /> <rect x="48" y="216" width="12" height="12" /> <rect x="60" y="216" width="12" height="12" /> <rect x="72" y="216" width="12" height="12" /> <rect x="96" y="216" width="12" height="12" /> <rect x="132" y="216" width="12" height="12" /> <rect x="156" y="216" width="12" height="12" /> <rect x="168" y="216" width="12" height="12" /> <rect x="192" y="216" width="12" height="12" /> <rect x="216" y="216" width="12" height="12" /> <rect x="240" y="216" width="12" height="12" /> <rect x="264" y="216" width="12" height="12" /> <rect x="276" y="216" width="12" height="12" /> <rect x="288" y="216" width="12" height="12" /> <rect x="0" y="228" width="12" height="12" /> <rect x="72" y="228" width="12" height="12" /> <rect x="108" y="228" width="12" height="12" /> <rect x="132" y="228" width="12" height="12" /> <rect x="144" y="228" width="12" height="12" /> <rect x="156" y="228" width="12" height="12" /> <rect x="168" y="228" width="12" height="12" /> <rect x="192" y="228" width="12" height="12" /> <rect x="240" y="228" width="12" height="12" /> <rect x="252" y="228" width="12" height="12" /> <rect x="288" y="228" width="12" height="12" /> <rect x="0" y="240" width="12" height="12" /> <rect x="24" y="240" width="12" height="12" /> <rect x="36" y="240" width="12" height="12" /> <rect x="48" y="240" width="12" height="12" /> <rect x="72" y="240" width="12" height="12" /> <rect x="96" y="240" width="12" height="12" /> <rect x="108" y="240" width="12" height="12" /> <rect x="144" y="240" width="12" height="12" /> <rect x="180" y="240" width="12" height="12" /> <rect x="192" y="240" width="12" height="12" /> <rect x="204" y="240" width="12" height="12" /> <rect x="216" y="240" width="12" height="12" /> <rect x="228" y="240" width="12" height="12" /> <rect x="240" y="240" width="12" height="12" /> <rect x="264" y="240" width="12" height="12" /> <rect x="276" y="240" width="12" height="12" /> <rect x="288" y="240" width="12" height="12" /> <rect x="0" y="252" width="12" height="12" /> <rect x="24" y="252" width="12" height="12" /> <rect x="36" y="252" width="12" height="12" /> <rect x="48" y="252" width="12" height="12" /> <rect x="72" y="252" width="12" height="12" /> <rect x="96" y="252" width="12" height="12" /> <rect x="144" y="252" width="12" height="12" /> <rect x="168" y="252" width="12" height="12" /> <rect x="216" y="252" width="12" height="12" /> <rect x="240" y="252" width="12" height="12" /> <rect x="252" y="252" width="12" height="12" /> <rect x="264" y="252" width="12" height="12" /> <rect x="276" y="252" width="12" height="12" /> <rect x="288" y="252" width="12" height="12" /> <rect x="0" y="264" width="12" height="12" /> <rect x="24" y="264" width="12" height="12" /> <rect x="36" y="264" width="12" height="12" /> <rect x="48" y="264" width="12" height="12" /> <rect x="72" y="264" width="12" height="12" /> <rect x="96" y="264" width="12" height="12" /> <rect x="120" y="264" width="12" height="12" /> <rect x="192" y="264" width="12" height="12" /> <rect x="252" y="264" width="12" height="12" /> <rect x="264" y="264" width="12" height="12" /> <rect x="288" y="264" width="12" height="12" /> <rect x="0" y="276" width="12" height="12" /> <rect x="72" y="276" width="12" height="12" /> <rect x="96" y="276" width="12" height="12" /> <rect x="108" y="276" width="12" height="12" /> <rect x="132" y="276" width="12" height="12" /> <rect x="144" y="276" width="12" height="12" /> <rect x="168" y="276" width="12" height="12" /> <rect x="180" y="276" width="12" height="12" /> <rect x="192" y="276" width="12" height="12" /> <rect x="204" y="276" width="12" height="12" /> <rect x="228" y="276" width="12" height="12" /> <rect x="240" y="276" width="12" height="12" /> <rect x="252" y="276" width="12" height="12" /> <rect x="288" y="276" width="12" height="12" /> <rect x="0" y="288" width="12" height="12" /> <rect x="12" y="288" width="12" height="12" /> <rect x="24" y="288" width="12" height="12" /> <rect x="36" y="288" width="12" height="12" /> <rect x="48" y="288" width="12" height="12" /> <rect x="60" y="288" width="12" height="12" /> <rect x="72" y="288" width="12" height="12" /> <rect x="96" y="288" width="12" height="12" /> <rect x="108" y="288" width="12" height="12" /> <rect x="120" y="288" width="12" height="12" /> <rect x="156" y="288" width="12" height="12" /> <rect x="228" y="288" width="12" height="12" /> <rect x="240" y="288" width="12" height="12" /> <rect x="252" y="288" width="12" height="12" /> <rect x="264" y="288" width="12" height="12" /> <rect x="276" y="288" width="12" height="12" /> <rect x="288" y="288" width="12" height="12" /> </g> </svg> </div> </div> </div> <a class="close-reveal-modal" aria-label="Close"> <i class="material-icons">clear</i> </a> </div> <a href="#" class="back-to-top"><span class="show-for-medium-up">Back to Top</span><span class="show-for-small">Top</span></a> <script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script><script src="https://pub.mdpi-res.com/assets/js/modernizr-2.8.3.min.js?5227e0738f7f421d?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/jquery-1.12.4.min.js?4f252523d4af0b47?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/foundation-5.5.3.min.js?6b2ec41c18b29054?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/foundation-5.5.3.equalizer.min.js?0f6c549b75ec554c?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/jquery.multiselect.js?0edd3998731d1091?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/jquery.cycle2.min.js?63413052928f97ee?1733310352"></script> <script> // old browser fix - this way the console log rows won't throw (silent) errors in browsers not supporting console log if (!window.console) window.console = {}; if (!window.console.log) window.console.log = function () { }; var currentJournalNameSystem = "rheumato"; $(document).ready(function() { $('select.foundation-select').multiselect({ search: true, minHeight: 130, maxHeight: 130, }); $(document).foundation({ orbit: { timer_speed: 4000, }, reveal: { animation: 'fadeAndPop', animation_speed: 100, } }); $(".chosen-select").each(function(element) { var maxSelected = (undefined !== $(this).data('maxselectedoptions') ? $(this).data('maxselectedoptions') : 100); $(this).on('chosen:ready', function(event, data) { var select = $(data.chosen.form_field); if (select.attr('id') === 'journal-browser-volume') { $(data.chosen.dropdown).addClass('UI_JournalBrowser_Volume_Options'); } if (select.attr('id') === 'journal-browser-issue') { $(data.chosen.dropdown).addClass('UI_JournalBrowser_Issue_Options'); } }).chosen({ display_disabled_options: false, disable_search_threshold: 7, max_selected_options: maxSelected, width: "100%" }); }); $(".toEncode").each(function(e) { var oldHref = $(this).attr("href"); var newHref = oldHref.replace('.botdefense.please.enable.javascript.','@'); $(this).attr("href", newHref); if (!$(this).hasClass("emailCaptcha")) { $(this).html(newHref.replace('mailto:', '')); } $(this).removeClass("visibility-hidden"); }); $(document).on('opened.fndtn.reveal', '[data-reveal]', function() { $(document).foundation('equalizer', 'reflow'); }); // fix the images that have tag height / width defined // otherwise the default foundation styles overwrite the tag definitions $("img").each(function() { if ($(this).attr('width') != undefined || $(this).attr('height') != undefined) { $(this).addClass("img-fixed"); } }); $("#basic_search, #advanced_search").submit(function(e) { var searchArguments = false; $(this).find("input,select").not("#search,.search-button").each(function() { if (undefined === $(this).val() || "" === $(this).val()) { $(this).attr('name', null); } else { $(this).attr('name'); searchArguments = true; } }); if (!searchArguments) { window.location = $(this).attr('action'); return false; } }); $(".hide-show-desktop-option").click(function(e) { e.preventDefault(); var parentDiv = $(this).closest("div"); $.ajax({ url: $(this).attr('href'), success: function(msg) { parentDiv.removeClass().hide(); } }); }); $(".generic-toggleable-header").click(function(e) { $(this).toggleClass("active"); $(this).next(".generic-toggleable-content").toggleClass("active"); }); /* * handle whole row as a link if the row contains only one visible link */ $("table.new tr").hover(function() { if ($(this).find("td:visible a").length == 1) { $(this).addClass("single-link"); } }, function() { $(this).removeClass("single-link"); }); $("table.new:not(.table-of-tables)").on("click", "tr.single-link", function(e) { var target = $(e.target); if (!e.ctrlKey && !target.is("a")) { $(this).find("td:visible a")[0].click(); } }); $(document).on("click", ".custom-accordion-for-small-screen-link", function(e) { if ($(this).closest("#basic_search").length > 0) { if ($(".search-container__advanced").first().is(":visible")) { openAdvanced() } } if (Foundation.utils.is_small_only()) { if ($(this).hasClass("active")) { $(this).removeClass("active"); $(this).next(".custom-accordion-for-small-screen-content").addClass("show-for-medium-up"); } else { $(this).addClass("active"); $(this).next(".custom-accordion-for-small-screen-content").removeClass("show-for-medium-up"); $(document).foundation('orbit', 'reflow'); } } if (undefined !== $(this).data("callback")) { var customCallback = $(this).data("callback"); func = window[customCallback]; func(); } }); $(document).on("click", ".js-open-small-search", function(e) { e.preventDefault(); $(this).toggleClass("active").closest(".tab-bar").toggleClass("active"); $(".search-container").toggleClass("hide-for-small-down"); }); $(document).on("click", ".js-open-menu", function(e) { $(".search-container").addClass("hide-for-small-down"); }); $(window).on('resize', function() { recalculate_main_browser_position(); recalculate_responsive_moving_containers(); }); updateSearchLabelVisibilities(); recalculate_main_browser_position(); recalculate_responsive_moving_containers(); if (window.document.documentMode == 11) { $("<link/>", { rel: "stylesheet", type: "text/css", href: "https://fonts.googleapis.com/icon?family=Material+Icons"}).appendTo("head"); } }); function recalculate_main_browser_position() { if (Foundation.utils.is_small_only()) { if ($("#js-main-top-container").parent("#js-large-main-top-container").length > 0) { $("#js-main-top-container").appendTo($("#js-small-main-top-container")); } } else { if ($("#js-main-top-container").parent("#js-small-main-top-container").length > 0) { $("#js-main-top-container").appendTo($("#js-large-main-top-container")); } } } function recalculate_responsive_moving_containers() { $(".responsive-moving-container.large").each(function() { var previousParent = $(".responsive-moving-container.active[data-id='"+$(this).data("id")+"']"); var movingContent = previousParent.html(); if (Foundation.utils.is_small_only()) { var currentParent = $(".responsive-moving-container.small[data-id='"+$(this).data("id")+"']"); } else if (Foundation.utils.is_medium_only()) { var currentParent = $(".responsive-moving-container.medium[data-id='"+$(this).data("id")+"']"); } else { var currentParent = $(".responsive-moving-container.large[data-id='"+$(this).data("id")+"']"); } if (previousParent.attr("class") !== currentParent.attr("class")) { currentParent.html(movingContent); previousParent.html(); currentParent.addClass("active"); previousParent.removeClass("active"); } }); } // cookies allowed is checked from a) local storage and b) from server separately so that the footer bar doesn't // get included in the custom page caches function checkCookiesAllowed() { var cookiesEnabled = localStorage.getItem("mdpi_cookies_enabled"); if (null === cookiesEnabled) { $.ajax({ url: "/ajax_cookie_value/mdpi_cookies_accepted", success: function(data) { if (data.value) { localStorage.setItem("mdpi_cookies_enabled", true); checkDisplaySurvey(); } else { $(".js-allow-cookies").show(); } } }); } else { checkDisplaySurvey(); } } function checkDisplaySurvey() { } window.addEventListener('CookiebotOnAccept', function (e) { var CookieDate = new Date; if (Cookiebot.consent.preferences) { CookieDate.setFullYear(CookieDate.getFullYear() + 1); document.cookie = "mdpi_layout_type_v2=mobile; path=/; expires=" + CookieDate.toUTCString() + ";"; $(".js-toggle-desktop-layout-link").css("display", "inline-block"); } }, false); window.addEventListener('CookiebotOnDecline', function (e) { if (!Cookiebot.consent.preferences) { $(".js-toggle-desktop-layout-link").hide(); if ("" === "desktop") { window.location = "/toggle_desktop_layout_cookie"; } } }, false); var hash = $(location).attr('hash'); if ("#share" === hash) { if (1 === $("#main-share-modal").length) { $('#main-share-modal').foundation('reveal', 'open'); } } </script> <script src="https://pub.mdpi-res.com/assets/js/lib.js?f8d3d71b3a772f9d?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/mdpi.js?c267ce58392b15da?1733310352"></script> <script>var banners_url = 'https://serve.mdpi.com';</script> <script type='text/javascript' src='https://pub.mdpi-res.com/assets/js/ifvisible.min.js?c621d19ecb761212?1733310352'></script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/affix.js?ac4ea55275297c15?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/clipboard.min.js?3f3688138a1b9fc4?1733310352"></script> <script type="text/javascript"> $(document).ready(function() { var helpFunctions = $(".middle-column__help__fixed"); var leftColumnAffix = $(".left-column__fixed"); var middleColumn = $("#middle-column"); var clone = null; helpFunctions.affix({ offset: { top: function() { return middleColumn.offset().top - 8 - (Foundation.utils.is_medium_only() ? 30 : 0); }, bottom: function() { return $("#footer").innerHeight() + 74 + (Foundation.utils.is_medium_only() ? 0 : 0); } } }); if (leftColumnAffix.length > 0) { clone = leftColumnAffix.clone(); clone.addClass("left-column__fixed__affix"); clone.insertBefore(leftColumnAffix); clone.css('width', leftColumnAffix.outerWidth() + 50); clone.affix({ offset: { top: function() { return leftColumnAffix.offset().top - 30 - (Foundation.utils.is_medium_only() ? 50 : 0); }, bottom: function() { return $("#footer").innerHeight() + 92 + (Foundation.utils.is_medium_only() ? 0 : 0); } } }); } $(window).on("resize", function() { if (clone !== null) { clone.css('width', leftColumnAffix.outerWidth() + 50); } }); new ClipboardJS('.js-clipboard-copy'); }); </script> <script src="https://pub.mdpi-res.com/assets/js/jquery-ui-1.13.2.min.js?1e2047978946a1d2?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/slick.min.js?d5a61c749e44e471?1733310352"></script> <script> $(document).ready(function() { $(".link-article-menu").click(function(e) { e.preventDefault(); $(this).find('span').toggle(); $(this).next("div").toggleClass("active"); }); $(".js-similarity-related-articles").click(function(e) { e.preventDefault(); if ('' !== $('#recommended-articles-modal').attr('data-url')) { $('#recommended-articles-modal').foundation('reveal', 'open', $('#recommended-articles-modal').attr('data-url')); } }); $.ajax({ url: "/article/1467592/similarity-related/show-link", success: function(result) { if (result.show) { $('#recommended-articles-modal').attr('data-url', result.link); $('.js-article-similarity-container').show(); } } }); $(document).on('opened.fndtn.reveal', '[data-reveal]', function() { var modal = $(this); if (modal.attr('id') === "author-biographies-modal") { modal.find('.multiple-items').slick({ slidesToShow: 1, nextArrow: '<a class="slick-next" href="#"><i class="material-icons">chevron_right</i></a>', prevArrow: '<a class="slick-prev" href="#"><i class="material-icons">chevron_left</i></a>', slidesToScroll: 1, draggable: false, }); modal.find('.multiple-items').slick('refresh'); } }); }); </script> <script> $(document).ready(function() { $(document).on('keyup', function (e) { if (e.keyCode == 27) { var hElem = $(this).find(".annotator-adder"); if (hElem.length){ hElem.css({'visibility':'hidden'}); } else { document.querySelector("hypothesis-adder").shadowRoot.querySelector(".annotator-adder").style.visibility = "hidden"; } } }); }); </script> <script> window.hypothesisConfig = function () { return { sidebarAppUrl: 'https://commenting.mdpi.com/app.html', showHighlights: 'whenSidebarOpen' , openSidebar: false , assetRoot: 'https://commentingres.mdpi.com/hypothesis', services: [{ apiUrl: 'https://commenting.mdpi.com/api/', authority: 'mdpi', grantToken: '', doi: '10.3390/rheumato4030012' }], }; }; </script> <script async id="hypothesis_frame"></script> <script type="text/javascript"> if (-1 !== window.location.href.indexOf("?src=")) { window.history.replaceState({}, '', `${location.pathname}`); } $(document).ready(function() { var scifeedCounter = 0; var search = window.location.search; var mathjaxReady = false; // late image file loading $("img[data-lsrc]").each(function() { $(this).attr("src", $(this).data("lsrc")); }); // late mathjax initialization var head = document.getElementsByTagName("head")[0]; var script = document.createElement("script"); script.type = "text/x-mathjax-config"; script[(window.opera ? "innerHTML" : "text")] = "MathJax.Hub.processSectionDelay = 0;\n" + "MathJax.Hub.Config({\n" + " \"menuSettings\": {\n" + " CHTMLpreview: false\n" + " },\n" + " \"CHTML-preview\":{\n" + " disabled: true\n" + " },\n" + " \"HTML-CSS\": {\n" + " scale: 90,\n" + " availableFonts: [],\n" + " preferredFont: null,\n" + " preferredFonts: null,\n" + " webFont:\"Gyre-Pagella\",\n" + " imageFont:'TeX',\n" + " undefinedFamily:\"'Arial Unicode MS',serif\",\n" + " linebreaks: { automatic: false }\n" + " },\n" + " \"TeX\": {\n" + " extensions: ['noErrors.js'],\n" + " noErrors: {\n" + " inlineDelimiters: [\"\",\"\"],\n" + " multiLine: true,\n" + " style: {\n" + " 'font-size': '90%',\n" + " 'text-align': 'left',\n" + " 'color': 'black',\n" + " 'padding': '1px 3px',\n" + " 'border': '1px solid'\n" + " }\n" + " }\n" + " }\n" + "});\n" + "MathJax.Hub.Register.StartupHook('End', function() {\n" + " refreshMathjaxWidths();\n" + " mathjaxReady = true;\n" + "});\n" + "MathJax.Hub.Startup.signal.Interest(function (message) {\n" + " if (message == 'End') {\n" + " var hypoLink = document.getElementById('hypothesis_frame');\n" + " if (null !== hypoLink) {\n" + " hypoLink.setAttribute('src', 'https://commenting.mdpi.com/embed.js');\n" + " }\n" + " }\n" + "});"; head.appendChild(script); script = document.createElement("script"); script.type = "text/javascript"; script.src = "https://pub.mdpi-res.com/bundles/mathjax/MathJax.js?config=TeX-AMS-MML_HTMLorMML"; head.appendChild(script); // article version checker if (0 === search.indexOf('?type=check_update&version=')) { $.ajax({ url: "/2674-0621/4/3/12" + "/versioncheck" + search, success: function(result) { $(".js-check-update-container").html(result); } }); } $('#feed_option').click(function() { // tracker if ($('#scifeed_clicked').length<1) { $(this).append('<span style="display:none" id="scifeed_clicked">done</span>'); } $('#feed_data').toggle('slide', { direction: 'up'}, '1000'); // slideToggle(700); OR toggle(700) $("#scifeed_error_msg").html('').hide(); $("#scifeed_notice_msg").html('').hide(); }); $('#feed_option').click(function(event) { setTimeout(function(){ var captchaSection = $("#captchaSection"); captchaSection.removeClass('ui-helper-hidden').find('input').prop('disabled', false); // var img = captchaSection.find('img'); // img.attr('src', img.data('url') + "?" + (new Date()).getTime()); // $(".captcha_reload").trigger("click"); var img = document.getElementById('gregwar_captcha_scifeed'); img.src = '/generate-captcha/gcb_captcha?n=' + (new Date()).getTime(); },800); }); $(document).on('click', '.split_feeds', function() { var name = $( this ).attr('name'); var flag = 1 - ($(this).is(":checked")*1); $('.split_feeds').each(function (index) { if ($( this ).attr('name') !== name) { $(this)[0].checked = flag; } }); }); $(document).on('click', '#scifeed_submit, #scifeed_submit1', function(event) { event.preventDefault(); $(".captcha_reload").trigger("click"); $("#scifeed_error_msg").html(""); $("#scifeed_error_msg").hide(); }); $(document).on('click', '.subscription_toggle', function(event) { if ($(this).val() === 'Create SciFeed' && $('#scifeed_hidden_flag').length>0) { event.preventDefault(); // alert('Here there would be a captcha because user is not logged in'); var captchaSection = $("#captchaSection"); if (captchaSection.hasClass('ui-helper-hidden')) { captchaSection.removeClass('ui-helper-hidden').find('input').prop('disabled', false); var img = captchaSection.find('img'); img.attr('src', img.data('url') + "?" + (new Date()).getTime()); $("#reloadCaptcha").trigger("click"); } } }); $(document).on('click', '.scifeed_msg', function(){ $(this).hide(); }); $(document).on('click', '.article-scilit-search', function(e) { e.preventDefault(); var data = $(".article-scilit-search-data").val(); var dataArray = data.split(';').map(function(keyword) { return "(\"" + keyword.trim() + "\")"; }); var searchQuery = dataArray.join(" OR "); var searchUrl = encodeURI("https://www.scilit.net/articles/search?q="+ searchQuery + "&advanced=1&highlight=1"); var win = window.open(searchUrl, '_blank'); if (win) { win.focus(); } else { window.location(searchUrl); } }); display_stats(); citedCount(); follow_goto(); // Select the node that will be observed for mutations const targetNodes = document.getElementsByClassName('hypothesis-count-container'); // Options for the observer (which mutations to observe) const config = { attributes: false, childList: true, subtree: false }; // Callback function to execute when mutations are observed const callback = function(mutationList, observer) { for(const mutation of mutationList) { if (mutation.type === 'childList') { let node = $(mutation.target); if (parseInt(node.html()) > 0) { node.show(); } } } }; // Create an observer instance linked to the callback function const observer = new MutationObserver(callback); // Start observing the target node for configured mutations for(const targetNode of targetNodes) { observer.observe(targetNode, config); } // Select the node that will be observed for mutations const mathjaxTargetNode = document.getElementById('middle-column'); // Callback function to execute when mutations are observed const mathjaxCallback = function(mutationList, observer) { if (mathjaxReady && typeof(MathJax) !== 'undefined') { refreshMathjaxWidths(); } }; // Create an observer instance linked to the callback function const mathjaxObserver = new ResizeObserver(mathjaxCallback); // Start observing the target node for configured mutations mathjaxObserver.observe(mathjaxTargetNode); }); /* END $(document).ready */ function refreshMathjaxWidths() { let width = ($('.html-body').width()*0.9) + "px"; $('.MathJax_Display').css('max-width', width); $('.MJXc-display').css('max-width', width); } function sendScifeedFrom(form) { if (!$('#scifeed_email').val().trim()) { // empty email alert('Please, provide an email for subscribe to this scifeed'); return false; } else if (!$('#captchaSection').hasClass('ui-helper-hidden') && !$('#captchaSection').find('input').val().trim()) { // empty captcha alert('Please, fill the captcha field.'); return false; } else if( ((($('#scifeed_form').find('input:checkbox:checked').length)-($('#split_feeds:checked').length))<1) || ($('#scifeed_kwd_txt').length < 0 && !$('#scifeed_kwd_txt').val().trim()) || ($('#scifeed_author_txt').length<0 &&!$('#scifeed_author_txt').val().trim()) ) { alert('You did not select anything to subscribe'); return false; } else if(($('#scifeed_form').find('input:checkbox:checked').length)-($('#split_feeds2:checked').length)<1){ alert("You did not select anything to subscribe"); return false; } else { var url = $('#scifeed_subscribe_url').html(); var formData = $(form).serializeArray(); $.post(url, formData).done(function (data) { if (JSON.parse(data)) { $('.scifeed_msg').hide(); var res = JSON.parse(data); var successFeeds = 0; var errorFeeds = 0; if (res) { $('.scifeed_msg').html(''); $.each(res, function (index, val) { if (val) { if (val.error) { errorFeeds++; $("#scifeed_error_msg").append(index+' - '+val.error+'<br>'); } if (val.notice) // for successful feed creation { successFeeds++; // $("#scifeed_notice_msg").append(index+' - '+val.notice+'<br>'); $("#scifeed_notice_msg").append('<li>'+index+'</li>'); } } }); if (successFeeds>0) { text = $('#scifeed_notice_msg').html(); text = 'The following feed'+(successFeeds>1?'s have':' has')+ ' been sucessfully created:<br><ul>'+ text + '</ul>' +($('#scifeed_hidden_flag').length>0 ? 'You are not logged in, so you probably need to validate '+ (successFeeds>1?'them':' it')+'.<br>' :'' ) +'Please check your email'+(successFeeds>1?'s':'')+' for more details.'; //(successFeeds>1?' for each of them':'')+'.<br>'; $("#scifeed_notice_msg").html(text); $("#scifeed_notice_msg").show(); } if (errorFeeds>0) { $("#scifeed_error_msg").show();; } } $("#feed_data").hide(); } }); } } function follow_goto() { var hashStr = location.hash.replace("#",""); if(typeof hashStr !== 'undefined') { if( hashStr == 'supplementary') { document.getElementById('suppl_id').scrollIntoView(); } if( hashStr == 'citedby') { document.getElementById('cited_id').scrollIntoView(); } } } function cited() { $("#framed_div").toggle('fast', function(){ if ($(this).css('display') != 'none') { var loaded = document.getElementById("loaded"); if(loaded.innerHTML == "No") { // Load Xref result var container = document.getElementById("framed_div"); // This replace the content container.innerHTML = "<img src=\"https://pub.mdpi-res.com/img/loading_circle.gif?9a82694213036313?1733310352\" height=\"20\" width=\"20\" alt=\"Processing...\" style=\"vertical-align:middle; margin-right:0.6em;\">"; var url = "/citedby/10.3390%252Frheumato4030012/506"; $.post(url, function(result) { if (result.success) { container.innerHTML = result.view; } loaded.innerHTML = "Yes"; }); } } return true; // for not going at the beginning of the page... }) return true; // for not going at the beginning of the page... } function detect_device() { // Added by Bastien (18/08/2014): based on the http://detectmobilebrowsers.com/ detector var check = false; (function(a){if(/(android|bb\d+|meego).+mobile|avantgo|bada\/|blackberry|blazer|compal|elaine|fennec|hiptop|iemobile|ip(hone|od)|iris|kindle|lge |maemo|midp|mmp|mobile.+firefox|netfront|opera m(ob|in)i|palm( os)?|phone|p(ixi|re)\/|plucker|pocket|psp|series(4|6)0|symbian|treo|up\.(browser|link)|vodafone|wap|windows (ce|phone)|xda|xiino/i.test(a)||/1207|6310|6590|3gso|4thp|50[1-6]i|770s|802s|a wa|abac|ac(er|oo|s\-)|ai(ko|rn)|al(av|ca|co)|amoi|an(ex|ny|yw)|aptu|ar(ch|go)|as(te|us)|attw|au(di|\-m|r |s )|avan|be(ck|ll|nq)|bi(lb|rd)|bl(ac|az)|br(e|v)w|bumb|bw\-(n|u)|c55\/|capi|ccwa|cdm\-|cell|chtm|cldc|cmd\-|co(mp|nd)|craw|da(it|ll|ng)|dbte|dc\-s|devi|dica|dmob|do(c|p)o|ds(12|\-d)|el(49|ai)|em(l2|ul)|er(ic|k0)|esl8|ez([4-7]0|os|wa|ze)|fetc|fly(\-|_)|g1 u|g560|gene|gf\-5|g\-mo|go(\.w|od)|gr(ad|un)|haie|hcit|hd\-(m|p|t)|hei\-|hi(pt|ta)|hp( i|ip)|hs\-c|ht(c(\-| |_|a|g|p|s|t)|tp)|hu(aw|tc)|i\-(20|go|ma)|i230|iac( |\-|\/)|ibro|idea|ig01|ikom|im1k|inno|ipaq|iris|ja(t|v)a|jbro|jemu|jigs|kddi|keji|kgt( |\/)|klon|kpt |kwc\-|kyo(c|k)|le(no|xi)|lg( g|\/(k|l|u)|50|54|\-[a-w])|libw|lynx|m1\-w|m3ga|m50\/|ma(te|ui|xo)|mc(01|21|ca)|m\-cr|me(rc|ri)|mi(o8|oa|ts)|mmef|mo(01|02|bi|de|do|t(\-| |o|v)|zz)|mt(50|p1|v )|mwbp|mywa|n10[0-2]|n20[2-3]|n30(0|2)|n50(0|2|5)|n7(0(0|1)|10)|ne((c|m)\-|on|tf|wf|wg|wt)|nok(6|i)|nzph|o2im|op(ti|wv)|oran|owg1|p800|pan(a|d|t)|pdxg|pg(13|\-([1-8]|c))|phil|pire|pl(ay|uc)|pn\-2|po(ck|rt|se)|prox|psio|pt\-g|qa\-a|qc(07|12|21|32|60|\-[2-7]|i\-)|qtek|r380|r600|raks|rim9|ro(ve|zo)|s55\/|sa(ge|ma|mm|ms|ny|va)|sc(01|h\-|oo|p\-)|sdk\/|se(c(\-|0|1)|47|mc|nd|ri)|sgh\-|shar|sie(\-|m)|sk\-0|sl(45|id)|sm(al|ar|b3|it|t5)|so(ft|ny)|sp(01|h\-|v\-|v )|sy(01|mb)|t2(18|50)|t6(00|10|18)|ta(gt|lk)|tcl\-|tdg\-|tel(i|m)|tim\-|t\-mo|to(pl|sh)|ts(70|m\-|m3|m5)|tx\-9|up(\.b|g1|si)|utst|v400|v750|veri|vi(rg|te)|vk(40|5[0-3]|\-v)|vm40|voda|vulc|vx(52|53|60|61|70|80|81|83|85|98)|w3c(\-| )|webc|whit|wi(g |nc|nw)|wmlb|wonu|x700|yas\-|your|zeto|zte\-/i.test(a.substr(0,4)))check = true})(navigator.userAgent||navigator.vendor||window.opera); return check; } function display_stats(){ $("#article_stats_div").toggle(); return false; } /* * Cited By Scopus */ function citedCount(){ $("#framed_div_cited_count").toggle('fast', function(){ if ($(this).css('display') != 'none') { var loaded = document.getElementById("loaded_cite_count"); // to load only once the result! if(loaded.innerHTML == "No") { // Load Xref result var d = document.getElementById("framed_div_cited_count"); // This replace the content d.innerHTML = "<img src=\"https://pub.mdpi-res.com/img/loading_circle.gif?9a82694213036313?1733310352\" height=\"20\" width=\"20\" alt=\"Processing...\" style=\"vertical-align:middle; margin-right:0.6em;\">"; $.ajax({ method : "POST", url : "/cite-count/10.3390%252Frheumato4030012", success : function(data) { if (data.succ) { d.innerHTML = data.view; loaded.innerHTML = "Yes"; follow_goto(); } } }); } } // end else return true; // for not going at the beginning of the page... }) return true; // for not going at the beginning of the page... } </script><script type="text/javascript" src="https://pub.mdpi-res.com/assets/js/third-party/highcharts/highcharts.js?bdd06f45e34c33df?1733310352"></script><script type="text/javascript" src="https://pub.mdpi-res.com/assets/js/third-party/highcharts/modules/exporting.js?944dc938d06de3a8?1733310352"></script><script type="text/javascript" defer="defer"> var advancedStatsData; var selectedStatsType = "abstract"; $(function(){ var countWrapper = $('#counts-wrapper'); $('#author_stats_id #type_links a').on('click', function(e) { e.preventDefault(); selectedStatsType = $(this).data('type'); $('#article_advanced_stats').vectorMap('set', 'values', advancedStatsData[selectedStatsType]); $('#advanced_stats_max').html(advancedStatsData[selectedStatsType].max); $('#type_links a').removeClass('active'); $(this).addClass('active'); }); $.get('/2674-0621/4/3/12/stats', function (result) { if (!result.success) { return; } // process article metrics part in left column var viewNumber = countWrapper.find(".view-number"); viewNumber.html(result.metrics.views); viewNumber.parent().toggleClass("count-div--grey", result.metrics.views == 0); var downloadNumber = countWrapper.find(".download-number"); downloadNumber.html(result.metrics.downloads); downloadNumber.parent().toggleClass("count-div--grey", result.metrics.downloads == 0); var citationsNumber = countWrapper.find(".citations-number"); citationsNumber.html(result.metrics.citations); citationsNumber.parent().toggleClass("count-div--grey", result.metrics.citations == 0); if (result.metrics.views > 0 || result.metrics.downloads > 0 || result.metrics.citations > 0) { countWrapper.find("#js-counts-wrapper__views, #js-counts-wrapper__downloads").addClass("visible").show(); if (result.metrics.citations > 0) { countWrapper.find('.citations-number').html(result.metrics.citations).show(); countWrapper.find("#js-counts-wrapper__citations").addClass("visible").show(); } else { countWrapper.find("#js-counts-wrapper__citations").remove(); } $("[data-id='article-counters']").removeClass("hidden"); } if (result.metrics.altmetrics_score > 0) { $("#js-altmetrics-donut").show(); } // process view chart in main column var jsondata = result.chart; var series = new Array(); $.each(jsondata.elements, function(i, element) { var dataValues = new Array(); $.each(element.values, function(i, value) { dataValues.push(new Array(value.tip, value.value)); }); series[i] = {name: element.text, data:dataValues}; }); Highcharts.setOptions({ chart: { style: { fontFamily: 'Arial,sans-serif' } } }); $('#article_stats_swf').highcharts({ chart: { type: 'line', width: $("#tabs").width() //* 0.91 }, credits: { enabled: false }, exporting: { enabled: true }, title: { text: jsondata.title.text, x: -20 //center }, xAxis: { categories: jsondata.x_axis.labels.labels, offset: jsondata.x_axis.offset, labels:{ step: jsondata.x_axis.labels.steps, rotation: 30 } }, yAxis: { max: jsondata.y_axis.max, min: jsondata.y_axis.min, offset: jsondata.y_axis.offset, labels: { steps: jsondata.y_axis.steps }, title: { enabled: false } }, tooltip: { formatter: function (){ return this.key.replace("#val#", this.y); } }, legend: { align: 'top', itemDistance: 50 }, series: series }); }); $('#supplement_link').click(function() { document.getElementById('suppl_id').scrollIntoView(); }); $('#stats_link').click(function() { document.getElementById('stats_id').scrollIntoView(); }); // open mol viewer for molbank special supplementary files $('.showJmol').click(function(e) { e.preventDefault(); var jmolModal = $("#jmolModal"); var url = "/article/1467592/jsmol_viewer/__supplementary_id__"; url = url.replace(/__supplementary_id__/g, $(this).data('index')); $('#jsmol-content').attr('src', url); jmolModal.find(".content").html($(this).data('description')); jmolModal.foundation("reveal", "open"); }); }); !function() { "use strict"; function e(e) { try { if ("undefined" == typeof console) return; "error"in console ? console.error(e) : console.log(e) } catch (e) {} } function t(e) { return d.innerHTML = '<a href="' + e.replace(/"/g, """) + '"></a>', d.childNodes[0].getAttribute("href") || "" } function n(n, c) { var o = ""; var k = parseInt(n.substr(c + 4, 2), 16); for (var i = c; i < n.length; i += 2) { if (i != c + 4) { var s = parseInt(n.substr(i, 2), 16) ^ k; o += String.fromCharCode(s); } } try { o = decodeURIComponent(escape(o)); } catch (error) { console.error(error); } return t(o); } function c(t) { for (var r = t.querySelectorAll("a"), c = 0; c < r.length; c++) try { var o = r[c] , a = o.href.indexOf(l); a > -1 && (o.href = "mailto:" + n(o.href, a + l.length)) } catch (i) { e(i) } } function o(t) { for (var r = t.querySelectorAll(u), c = 0; c < r.length; c++) try { var o = r[c] , a = o.parentNode , i = o.getAttribute(f); if (i) { var l = n(i, 0) , d = document.createTextNode(l); a.replaceChild(d, o) } } catch (h) { e(h) } } function a(t) { for (var r = t.querySelectorAll("template"), n = 0; n < r.length; n++) try { i(r[n].content) } catch (c) { e(c) } } function i(t) { try { c(t), o(t), a(t) } catch (r) { e(r) } } var l = "/cnd-cgi/l/email-protection#" , u = ".__cf_email__" , f = "data-cfemail" , d = document.createElement("div"); i(document), function() { var e = document.currentScript || document.scripts[document.scripts.length - 1]; e.parentNode.removeChild(e) }() }(); </script><script type="text/javascript"> function setCookie(cname, cvalue, ctime) { ctime = (typeof ctime === 'undefined') ? 10*365*24*60*60*1000 : ctime; // default => 10 years var d = new Date(); d.setTime(d.getTime() + ctime); // ==> 1 hour = 60*60*1000 var expires = "expires="+d.toUTCString(); document.cookie = cname + "=" + cvalue + "; " + expires +"; path=/"; } function getCookie(cname) { var name = cname + "="; var ca = document.cookie.split(';'); for(var i=0; i<ca.length; i++) { var c = ca[i]; while (c.charAt(0)==' ') c = c.substring(1); if (c.indexOf(name) == 0) return c.substring(name.length, c.length); } return ""; } </script><script type="text/javascript" src="https://d1bxh8uas1mnw7.cloudfront.net/assets/embed.js"></script><script> $(document).ready(function() { if ($("#js-similarity-related-data").length > 0) { $.ajax({ url: '/article/1467592/similarity-related', success: function(response) { $("#js-similarity-related-data").html(response); $("#js-related-articles-menu").show(); $(document).foundation('tab', 'reflow'); MathJax.Hub.Queue(["Typeset", MathJax.Hub]); } }); } }); </script><link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/jquery-ui-1.10.4.custom.min.css?80647d88647bf347?1733310352"><link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/magnific-popup.min.css?04d343e036f8eecd?1733310352"><script type="text/javascript" src="https://pub.mdpi-res.com/assets/js/magnific-popup.min.js?2be3d9e7dc569146?1733310352"></script><script> $(function() { $(".js-show-more-academic-editors").on("click", function(e) { e.preventDefault(); $(this).hide(); $(".academic-editor-container").removeClass("hidden"); }); }); </script> <link rel="stylesheet" href="https://pub.mdpi-res.com/assets/css/vmap/jqvmap.min.css?126a06688aa11c13?1733310352"> <script src="https://pub.mdpi-res.com/assets/js/vmap/jquery.vmap.min.js?935f68d33bdd88a1?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/vmap/jquery.vmap.world.js?16677403c0e1bef1?1733310352"></script> <script> function updateSlick() { $('.multiple-items').slick('setPosition'); } $(document).ready(function() { $('.multiple-items').slick({ slidesToShow: 1, nextArrow: '<a class="slick-next" href="#"><i class="material-icons">chevron_right</i></a>', prevArrow: '<a class="slick-prev" href="#"><i class="material-icons">chevron_left</i></a>', slidesToScroll: 1, responsive: [ { breakpoint: 1024, settings: { slidesToShow: 1, slidesToScroll: 1, } }, { breakpoint: 600, settings: { slidesToShow: 1, slidesToScroll: 1, } }, { breakpoint: 480, settings: { slidesToShow: 1, slidesToScroll: 1, } } ] }); $('.multiple-items').show(); $(document).on('click', '.reviewReportSelector', function(e) { let path = $(this).attr('data-path'); handleReviews(path, $(this)); }); $(document).on('click', '.viewReviewReports', function(e) { let versionOne = $('#versionTab_1'); if (!versionOne.hasClass('activeTab')) { let path = $(this).attr('data-path'); handleReviews(path, versionOne); } location.href = "#reviewReports"; }); $(document).on('click', '.reviewersResponse, .authorResponse', function(e) { let version = $(this).attr('data-version'); let targetVersion = $('#versionTab_' + version); if (!targetVersion.hasClass('activeTab')) { let path = targetVersion.attr('data-path'); handleReviews(path, targetVersion); } location.href = $(this).attr('data-link'); }); $(document).on('click', '.tab', function (e) { e.preventDefault(); $('.tab').removeClass('activeTab'); $(this).addClass('activeTab') $('.tab').each(function() { $(this).closest('.tab-title').removeClass('active'); }); $(this).closest('.tab-title').addClass('active') }); }); function handleReviews(path, target) { $.ajax({ url: path, context: this, success: function (data) { $('.activeTab').removeClass('activeTab'); target.addClass('activeTab'); $('#reviewSection').html(data.view); }, error: function (xhr, ajaxOptions, thrownError) { console.log(xhr.status); console.log(thrownError); } }); } </script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/affix.js?v1?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/storage.js?e9b262d3a3476d25?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/jquery-scrollspy.js?09cbaec0dbb35a67?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/magnific-popup.js?4a09c18460afb26c?1733310352"></script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/underscore.js?f893e294cde60c24?1733310352"></script> <script type="text/javascript"> $('document').ready(function(){ $("#left-column").addClass("show-for-large-up"); $("#middle-column").removeClass("medium-9").removeClass("left-bordered").addClass("medium-12"); $(window).on('resize scroll', function() { /* if ($('.button--drop-down').isInViewport($(".top-bar").outerHeight())) { */ if ($('.button--drop-down').isInViewport()) { $("#js-button-download").hide(); } else { $("#js-button-download").show(); } }); }); $(document).on('DOMNodeInserted', function(e) { var element = $(e.target); if (element.hasClass('menu') && element.hasClass('html-nav') ) { element.addClass("side-menu-ul"); } }); </script> <script src="https://pub.mdpi-res.com/assets/js/xmltohtml/articles.js?5118449d9ad8913a?1733310352"></script> <script> repositionOpenSideBar = function() { $('#left-column').addClass("show-for-large-up show-for-medium-up").show(); $('#middle-column').removeClass('large-12').removeClass('medium-12'); $('#middle-column').addClass('large-9'); } repositionCloseSideBar = function() { $('#left-column').removeClass("show-for-large-up show-for-medium-up").hide(); $('#middle-column').removeClass('large-9'); $('#middle-column').addClass('large-12').addClass('medium-12'); } </script>   <script type="text/plain" data-cookieconsent="marketing"> !function(e,t,n,s,u,a){e.twq||(s=e.twq=function(){s.exe?s.exe.apply(s,arguments):s.queue.push(arguments); },s.version='1.1',s.queue=[],u=t.createElement(n),u.async=!0,u.src='//static.ads-twitter.com/uwt.js', a=t.getElementsByTagName(n)[0],a.parentNode.insertBefore(u,a))}(window,document,'script'); // Insert Twitter Pixel ID and Standard Event data below twq('init','o2pip'); twq('track','PageView'); </script>  <script>(function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'8ece388d3afb3e3b',t:'MTczMzM0MDczMS4wMDAwMDA='};var a=document.createElement('script');a.nonce='';a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();</script></body> </html>

CINXE.COM

Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren&rsquo;s Disease

Presentation, Characteristics and Features of Lymphoma in a Retrospective Case Series of Patients with Sjogren’s Disease