A retrospective cohort study suggested that a focus score of ≥3 in a labial salivary gland biopsy was an independent predictor of the development of non-Hodgkin lymphoma in patients with primary SS.[16] In addition, a germ center-like structure could be referred to as a sign of developing malignant lymphoma in SS patients.[17] It is conceivable that examination of excessive CD30 expression in lacrimal gland and conjunctival tissues may become an additional option to predict the initiation and propagation of ML. Here, TNFRSF8 is linked to lymphoma.