In patients with secondary Sjogren's how do you approach screening for lymphoproliferative malignancy?

1. Firstly, I do not discriminate between "secondary" and "primary" Sjogren's disease. There is currently a "Nomenclature Initiative" by the Sjogren's Foundation, led by Dr. Alan Baer, Director of the Sjögren’s Clinic at Johns Hopkins, and Dr. Manuel Ramos-Casals, a Sjogren's expert in Spain. Thus far, the consensus looks promising for dropping "syndrome" and calling it "Sjogren's disease", and there is a popular push to get rid of "primary" and "secondary." Using "secondary" tends to diminish noting the Sjogren's involvement in the patient. For example, 15-20% of Sjogren's patients get lung involvement. Hopefully, labeling a patient as having "Sjogren's with RA overlap" would help remind clinicians to remember the Sjogren's complications (...