The presence of germinal centre-like structures (GCs) in the salivary glands of pSS patients has been generally associated with a more intense clinical disease as reflected by a higher focus score (FS) and increased positivity for anti-SSA/Ro and anti-SSB/La autoantibodies.5,21 Their association with the risk of lymphoma development is still under debate. Here, CALR is linked to lymphoma.