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Due to history of decreased appetite, weight loss and poor therapeutic response, further evaluation was performed, revealing elevated C-Reactive Peptide, Desmoglein-3 antibody, Carbohydrate Antigen 19\u20139, and intraperitoneal lobulated homogeneously enhancing nodal mass, the latter indicating lymphoma. Histopathology from oral mucosa was suggestive of paraneoplastic pemphigus. The patient was referred to oncology department for further management. This case underscores the importance of thorough evaluation in elderly patients with recalcitrant mucocutaneous lesions with atypical histopathology.<\/jats:p>","DOI":"10.1093\/omcr\/omaf124","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T22:57:27Z","timestamp":1755039447000},"source":"Crossref","is-referenced-by-count":0,"title":["From oral erosions to lymphoma: a case of paraneoplastic pemphigus with occult lymphoma"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8118-7849","authenticated-orcid":false,"given":"Kumari","family":"Monalisa","sequence":"first","affiliation":[{"name":"Specialist Medical Officer (Department of Dermatology), UPHC Uttarwari Pokhra, Bettiah, West Champaran, Bihar, 845438,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2425-0226","authenticated-orcid":false,"given":"Tanvi","family":"Dev","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Maulana Azad Medical College & Lok Nayak Hospital , Bahadur Shah Zafar Marg, New Delhi 110002 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaishnavi","family":"Modi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Maulana Azad Medical College & Lok Nayak Hospital , Bahadur Shah Zafar Marg, New Delhi 110002 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akarshi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiology, Maulana Azad Medical College & Lok Nayak Hospital , Bahadur Shah Zafar Marg, New Delhi 110002 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varuna","family":"Mallya","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maulana Azad Medical College & Lok Nayak Hospital , Bahadur Shah Zafar Marg, New Delhi 110002 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi","family":"Dixit","sequence":"additional","affiliation":[{"name":"Department of Radiology, Maulana Azad Medical College & Lok Nayak Hospital , Bahadur Shah Zafar Marg, New Delhi 110002 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"2025082502171905900_ref1","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1111\/cup.14004","article-title":"Paraneoplastic pemphigus: revised diagnostic criteria based on literature analysis","volume":"48","author":"Svoboda","year":"2021","journal-title":"J Cutan Pathol"},{"key":"2025082502171905900_ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/3641474","article-title":"Paraneoplastic pemphigus: a striking complication of undiagnosed lymphoma","volume":"2022","author":"Adnani","year":"2022","journal-title":"Case Rep Hematol"},{"key":"2025082502171905900_ref3","doi-asserted-by":"publisher","first-page":"2532","DOI":"10.3390\/ijms18122532","article-title":"Paraneoplastic pemphigus: insight into the autoimmune pathogenesis, clinical features and therapy","volume":"18","author":"Paolino","year":"2017","journal-title":"Int J Mol Sci"},{"key":"2025082502171905900_ref4","doi-asserted-by":"publisher","first-page":"253","DOI":"10.2340\/0001555576253254","article-title":"Paraneoplastic pemphigus: oral involvement as the sole manifestation","volume":"76","author":"Bialy-Golan","year":"1996","journal-title":"Acta Derm Venereol"},{"key":"2025082502171905900_ref5","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/S0733-8635(18)30244-4","article-title":"Paraneoplastic pemphigus","volume":"11","author":"Mutasim","year":"1993","journal-title":"Dermatol Clin"},{"key":"2025082502171905900_ref6","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1590\/abd1806-4841.20199165","article-title":"Paraneoplastic pemphigus: a clinical, laboratorial, and therapeutic overview","volume":"94","author":"Maruta","year":"2019","journal-title":"An Bras Dermatol"},{"key":"2025082502171905900_ref7","doi-asserted-by":"publisher","first-page":"37654084","DOI":"10.1177\/2515690X231198315","article-title":"Clinicopathological characteristics and prognosis of diffuse large B-cell lymphoma in relation to CA-125 and CA 19-9 expression. 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