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The challenge to interpret conflicting results and the need of a univocal definition for germinal centres in primary Sjögren’s syndrome
  1. Alessia Alunno1,
  2. Francesco Carubbi2,3,
  3. Roberto Giacomelli3,
  4. Roberto Gerli1
  1. 1 Department of Medicine, Rheumatology Unit, University of Perugia, Perugia, Italy
  2. 2 Department of Medicine, ASL1 Avezzano, Sulmona, L’Aquila, Italy
  3. 3 Department of Applied and Biotechnological Clinical Sciences, Rheumatology Unit, University of L’Aquila, L’Aquila, Italy
  1. Correspondence to Professor Roberto Gerli, Department of Medicine, Rheumatology Unit, University of Perugia, Piazzale Gambuli 1, 06129, Perugia, Italy; roberto.gerli{at}unipg.it

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We read with interest the article by Haacke et al 1 demonstrating that the presence of germinal centres (GCs) in minor salivary glands (MSG) of patients with primary Sjögren’s syndrome (pSS) does not differ between subjects developing non-Hodgkin’s lymphoma (NHL) and those who do not develop this complication. In recent years the prognostic role of MSG histopathology has been a matter of intense debate. The severity of the inflammatory infiltrate as defined by the focus score (FS) and/or by the presence of ectopic lymphoid structures (ELS) has been associated with a severe clinical picture characterised by extraglandular manifestations as well as NHL.2–5 Although the calculation of FS is rather intuitive and reproducible,6 making the comparison of different studies easy, discrepancies arise with …

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