Objectives: To explore the relevance of T-follicular-helper (Tfh) and pathogenic peripheral-helper T-cells (Tph) in promoting ectopic lymphoid structures (ELS) and B-cell mucosa-associated lymphoid tissue (MALT) lymphomas (MALT-L) in Sjögren''s syndrome (SS) patients. Methods: Salivary gland (SG) biopsies with matched peripheral blood were collected from four centres across the European Union.