Old pSS patients had higher frequency of dry mouth (96.9 vs. 92.9%, p = 0.046; OR = 2.39, 95% CI: 1.11–5.45), ILD 7.9 vs. 2.5%, p = 0.005; OR = 3.40, 95% CI: 1.50–8.47), and lymphoma [6.8% (n = 20/293) vs. 2.1% (n = 6/285)], p = 0.011; OR = 3.40, 95% CI: 1.34-8.17) and lower frequency of arthritis (10.2 vs. 17.1%, p = 0.040; OR = 1.81, 95% CI: 1.04–3.07), anti-Ro/SSA (67.9 vs. 79.3%, p = 0.002; OR = 1.81, 95% CI: 1.23–2.68), and hypergammaglobulinemia (43.6 vs. 62.1%, p < 0.001; OR = 2.12, 95% CI: 1.48–3.06) compared to the middle aged matched controls (Table 3). The gene discussed is CALR; the disease is lymphoma.