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Plasmablastic lymphoma of the oral cavity in an HIV-positive patient: Assessment by 18F FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2023; 42:46-47. [PMID: 34663556 DOI: 10.1016/j.remnie.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/18/2021] [Indexed: 02/01/2023]
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2
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Tian Y, Zhang Y, He Y, Wen B, Li C. Linfoma plasmablástico de cavidad oral en paciente VIH positivo: valoración por18F FDG PET/TC. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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3
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Pather S, MacKinnon D, Padayachee RS. Plasmablastic lymphoma in pediatric patients: clinicopathologic study of three cases. Ann Diagn Pathol 2012; 17:80-4. [PMID: 23036261 DOI: 10.1016/j.anndiagpath.2012.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 08/07/2012] [Accepted: 08/07/2012] [Indexed: 11/16/2022]
Abstract
Plasmablastic lymphoma (PBL) is an aggressive high grade non-Hodgkin lymphoma which occurs predominantly in adult patients who are concomitantly afflicted with HIV infection. In contrast to several reports and studies of PBL in adult patients, PBL has very rarely been reported in pediatric patients. This article hereby provides collaborative clinicopathologic information of de novo PBL diagnosed in 3 pediatric patients with concomitant HIV infection. Cognizance of this rare tumor in the pediatric population coupled with antiretroviral therapy and prompt initiation of multimodality treatment may, in the future, facilitate improved outcome in pediatric patients with PBL.
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Affiliation(s)
- Sugeshnee Pather
- Department of Anatomical Pathology, National Health Laboratory Service, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Castellarin P, Pozzato G, Tirelli G, Di Lenarda R, Biasotto M. Oral lesions and lymphoproliferative disorders. JOURNAL OF ONCOLOGY 2010; 2010:202305. [PMID: 20871659 PMCID: PMC2939410 DOI: 10.1155/2010/202305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 07/13/2010] [Accepted: 07/26/2010] [Indexed: 11/17/2022]
Abstract
Lymphoproliferative disorders are heterogeneous malignancy characterized by the expansion of a lymphoid clone more or less differentiated. At the level of the oral cavity, the lymphoproliferative disorder can occur in various ways, most commonly as lymphoid lesions with extranodal externalization, but sometimes, oral lesions may represent a localization of a disease spread. With regard to the primary localizations of lymphoproliferative disorders, a careful examination of the head and neck, oral, and oropharyngeal area is necessary in order to identify suspicious lesions, and their early detection results in a better prognosis for the patient. Numerous complications have been described and frequently found at oral level, due to pathology or different therapeutic strategies. These complications require precise diagnosis and measures to oral health care. In all this, oral pathologists, as well as dental practitioners, have a central role in the treatment and long-term monitoring of these patients.
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Affiliation(s)
- P. Castellarin
- Department of Dental Science, University of Trieste, 34127 Trieste, Italy
| | - G. Pozzato
- Department of Haematology, University of Trieste, 34142 Trieste, Italy
| | - G. Tirelli
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Trieste, 34127 Trieste, Italy
| | - R. Di Lenarda
- Department of Dental Science, University of Trieste, 34127 Trieste, Italy
| | - M. Biasotto
- Department of Dental Science, University of Trieste, 34127 Trieste, Italy
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5
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Guan B, Zhang X, Hu W, Rao Q, Wang Y, Zhu Y, Wang H, Ma H, Zhou H, Zhou X. Plasmablastic lymphoma of the oral cavity in an HIV-negative patient. Ann Diagn Pathol 2010; 15:436-40. [PMID: 20952277 DOI: 10.1016/j.anndiagpath.2010.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Revised: 05/10/2010] [Accepted: 05/27/2010] [Indexed: 10/19/2022]
Abstract
Plasmablastic lymphoma (PBL) is a rare, highly aggressive lymphoma typified by immunoblast-like cells with abundant basophilic cytoplasm and paranuclear hof. It shows absent expression of CD45 and CD20. In contrast, it displays a constant reaction with CD138 and VS38c. It may be easily misinterpreted as some other lymphoma. An exhaustive integration of clinical, morphologic, phenotypic, and molecular features is important to exclude misdiagnosis and inappropriate treatment. We report a case of HIV-negative PBL arising on the left areas of posterior teeth mucosa of a 58-year-old man. Immunohistochemically, the tumor cell was immunoreactive for CD138, VS38c, VEGF, and vimentin; Ki-67 showed a high proliferation rate. Epstein-Barr virus (in situ hybridization) was nonreactive, and IgH gene rearrangement was identified by polymerase chain reaction amplification products. A diagnosis of PBL was rendered.
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Affiliation(s)
- Bing Guan
- Department of Pathology, School of Medicine Nanjing University/Nanjing Jinling Hospital, Nanjing 210002, PR China
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6
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Sarode SC, Sarode GS, Patil A. Plasmablastic lymphoma of the oral cavity: A review. Oral Oncol 2010; 46:146-53. [DOI: 10.1016/j.oraloncology.2009.12.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 12/20/2009] [Accepted: 12/21/2009] [Indexed: 12/26/2022]
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Cha JM, Lee JI, Joo KR, Jung SW, Shin HP, Lee JJ, Kim GY. A case report with plasmablastic lymphoma of the jejunum. J Korean Med Sci 2010; 25:496-500. [PMID: 20191056 PMCID: PMC2826724 DOI: 10.3346/jkms.2010.25.3.496] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 11/12/2008] [Indexed: 12/14/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is a recently identified entity that is considered to be a type of diffuse large B-cell lymphoma with a unique immunophenotype and a predilection for the oral cavity of patients with the human immunodeficiency virus (HIV). Although its clinical features may help in the differential diagnosis, an extraoral location in a patient without HIV makes it more difficult to suspect clinically. This case report is the first to describe a patient with PBL originating from the jejunum in a 60-yr-old, HIV-seronegative man. Computed tomography of the face, chest and abdomen showed about a 9.4 x 9.0 cm mass of the proximal jejunum, multiple masses in the musculoskeletal soft tissue, and multiple lymphadenopathies. The histological examinations demonstrated a large cell lymphoma with plasmablastic differentiation. The neoplastic cells were diffusely positive for MUM1, epithelial membrane antigen and lambda light chains, and focally positive for CD79a; but negative for CD3, CD20, CD30, CD34, CD45RO, CD56, CD99, and CD117. The proliferation index by Ki-67 immunohistochemistry was approximately 70%. These findings were compatible with the diagnosis of PBL. The findings in this case suggest that PBL should be included in the differential diagnosis of a small bowel mass even in a HIV-negative patient.
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Affiliation(s)
- Jae Myung Cha
- Department of Internal Medicine, University of Kyunghee College of Medicine, Seoul, Korea.
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Plasmablastic lymphoma of the oral cavity in an HIV-positive patient: a case report and review of literature. Int J Oral Maxillofac Surg 2009; 38:993-9. [PMID: 19443181 DOI: 10.1016/j.ijom.2009.03.720] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 08/15/2008] [Accepted: 03/30/2009] [Indexed: 11/21/2022]
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Mendoza N, Diamantis M, Arora A, Bartlett B, Gewirtzman A, Tremaine AM, Tyring S. Mucocutaneous manifestations of Epstein-Barr virus infection. Am J Clin Dermatol 2009; 9:295-305. [PMID: 18717604 DOI: 10.2165/00128071-200809050-00003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This review focuses on Epstein-Barr virus (EBV) infection, diagnosis, and current treatment, with emphasis on EBV-associated mucocutaneous manifestations in primary infections, acute EBV-associated syndromes, chronic infections, lymphoproliferative disorders, and lymphomas. In primary infection, EBV infects B cells and can cause mucocutaneous manifestations in infectious mononucleosis or acute EBV-associated syndromes such as Gianotti-Crosti syndrome and hemophagocytic syndrome. EBV then persists in the majority of humans generally without causing disease. In some cases, however, latent EBV infection may result in diseases such as hydroa vacciniforme, hypersensitivity to mosquito bites, and lymphoproliferative disorders such as plasmablastic lymphoma, oral hairy leukoplakia, and post-transplant lymphoproliferative disorders, particularly in immunocompromised patients. Latent EBV infection has also been implicated in a variety of malignant conditions such as Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, and Kikuchi histocytic necrotizing lymphadenitis. Since the immune system is critical in preventing the progression of EBV disease, the immunologic status of the patient plays a crucial role in the subsequent development of pathologies.
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Abstract
Plasmablastic lymphoma (PBL) has been recently characterised as an aggressive subtype of non-Hodgkin's lymphoma, most frequently arising in the oral cavity of HIV-infected patients. To date, approximately 60 cases fulfilling the clinico-pathological characteristics of PBL have been reported. PBLs are composed of large cells with eccentrically located nuclei and deeply basophilic cytoplasm with a paranuclear hof. The tumour cells are invariably immunoreactive for the plasma cell marker CD138, and show monoclonal rearrangement of the immunoglobulin heavy chain gene (IgH) and/or clonal restriction of the Ig light chain (IgL) gene expression in most of the cases. Similar to other types of AIDS-related lymphomas, there is evidence that Epstein-Barr virus and Kaposi-sarcoma associated Human Herpes Virus 8 may play a relevant role in the pathogenesis of PBL. PBL patients have been treated heterogeneously, with a combination of chemotherapy, radiotherapy and/or surgery, and their prognosis is usually poor, with a death rate of approximately 60% at 1 year.
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Affiliation(s)
- P Rafaniello Raviele
- Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Milan, Italy
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Castillo J, Pantanowitz L, Dezube BJ. HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83:804-9. [PMID: 18756521 DOI: 10.1002/ajh.21250] [Citation(s) in RCA: 199] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Plasmablastic lymphoma (PBL) is a distinct subtype of non-Hodgkin B-cell lymphoma, originally described with a strong predilection to the oral cavity of human immunodeficiency virus (HIV)-infected individuals. Data regarding patient age and gender, HIV status, initiation of and response to highly active antiretroviral therapy (HAART), tumor extent, pathology, treatment, and outcome were extracted from 112 cases of PBL identified in the literature. The median age at presentation was 38 years with a male predominance of 7:1, and the median CD4+ count was 178 cells/mm(3). PBL presented on average 5 years after diagnosis of HIV. Common primary sites of presentation included the oral cavity, gastrointestinal tract, and lymph nodes. Most cases presented with either stage I or stage IV disease. There was a variable expression of B-cell markers in tumor cells, but plasma cell markers were expressed in all cases. EBV was detected in 74%. Chemotherapy was used to treat 55% patients and was combined with radiotherapy in 21% cases. Complete response was obtained in 66% of treated cases; the majority of these responses were seen after CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). The refractory/relapsed disease rate was 54%. Death occurred in 53% of patients, with a median overall survival of 15 months. Sex, CD4+ count, viral load, clinical stage, EBV status, primary site of involvement, and use of CHOP failed to show an association with survival. PBL is an aggressive B-cell lymphoma that presents in both oral and extra-oral sites of chronically HIV-infected immunosuppressed young men.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active/methods
- CD4 Lymphocyte Count
- Combined Modality Therapy/statistics & numerical data
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Herpesvirus 4, Human/isolation & purification
- Humans
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/mortality
- Lymphoma, AIDS-Related/therapy
- Lymphoma, Large-Cell, Immunoblastic/complications
- Lymphoma, Large-Cell, Immunoblastic/epidemiology
- Lymphoma, Large-Cell, Immunoblastic/mortality
- Lymphoma, Large-Cell, Immunoblastic/therapy
- Prednisone/therapeutic use
- Survival Analysis
- Vincristine/therapeutic use
- Viral Load
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Affiliation(s)
- Jorge Castillo
- Division of Hematology/Oncology, The Miriam Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island 02906, USA.
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Plasmablastic lymphoma: CNS involvement, coexistence of other malignancies, possible viral etiology, and dismal outcome. Ann Hematol 2008; 88:351-8. [DOI: 10.1007/s00277-008-0601-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 08/21/2008] [Indexed: 11/27/2022]
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Vieira FO, El Gandour O, Buadi FK, Williams GB, Shires CB, Zafar N. Plasmablastic lymphoma in a previously undiagnosed AIDS patient: a case report. Head Neck Pathol 2008; 2:92-6. [PMID: 20614329 PMCID: PMC2807551 DOI: 10.1007/s12105-008-0058-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2008] [Accepted: 04/23/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Plasmablastic lymphoma (PBL) is an unusual non-Hodgkin lymphoma (NHL) most commonly found in the head and neck region. The majority of cases are seen in adult HIV-positive patients, although PBL has been reported in HIV-negative patients. The diagnosis of PBL serves as an AIDS-defining illness. METHODS We report a case of PBL localized to the oral cavity in a previously undiagnosed AIDS patient. The lesion manifested as solitary, ulcerated, and markedly tender. PBL was confirmed by immunohistochemical profile and subsequent tests confirmed AIDS diagnosis. The patient was prescribed highly active antiretroviral therapy (HAART) and concomitant local low dose radiation therapy prior to initiation of chemotherapy. RESULTS Complete local clinical response was observed after 4 weeks of treatment with HAART and radiation therapy. The response sustained in this patient in the subsequent 11 months following diagnosis. CONCLUSIONS The diagnosis of PBL has a unique immunophenotypic profile and should raise suspicion for AIDS in these patients. HAART added to treatment has shown improved survival.
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Affiliation(s)
- Francisco O. Vieira
- Department of Otolaryngology—Head and Neck Surgery, University of Tennessee at Memphis, Health Science Center, 920 Madison St., S. 409, Memphis, TN 38103 USA ,The Med Regional Medical Center, Memphis, TN 38103 USA
| | - Omar El Gandour
- Department of Radiation Oncology, University of Tennessee Cancer Institute, Memphis, TN 38103 USA
| | | | - Glenn B. Williams
- Department of Otolaryngology—Head and Neck Surgery, University of Tennessee at Memphis, Health Science Center, 920 Madison St., S. 409, Memphis, TN 38103 USA
| | - Courtney B. Shires
- Department of Otolaryngology—Head and Neck Surgery, University of Tennessee at Memphis, Health Science Center, 920 Madison St., S. 409, Memphis, TN 38103 USA
| | - Nadeem Zafar
- The Med Regional Medical Center, Memphis, TN 38103 USA ,Department of Pathology, University of Tennessee Health Science Center, Memphis, TN 38163 USA
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Riedel DJ, Gonzalez-Cuyar LF, Zhao XF, Redfield RR, Gilliam BL. Plasmablastic lymphoma of the oral cavity: a rapidly progressive lymphoma associated with HIV infection. THE LANCET. INFECTIOUS DISEASES 2008; 8:261-7. [PMID: 18353267 DOI: 10.1016/s1473-3099(08)70067-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Plasmablastic lymphoma of the oral cavity is a form of non-Hodgkin lymphoma (NHL) and was first described in 1997. We describe a case of plasmablastic lymphoma in an HIV-infected patient who presented with an expanding oral lesion and symptoms of a toothache. We review all cases of plasmablastic lymphoma that have been reported in the literature. Plasmablastic lymphoma is strongly associated with immunodeficiency, and most particularly, with HIV infection. The pathophysiological origin of plasmablastic lymphoma has not been fully characterised, but the presence of Epstein-Barr virus (EBV) has often been documented in biopsy specimens, supporting a role for EBV in the pathogenesis of this lymphoma. The differential diagnosis for an expanding oral lesion includes both infectious and malignant processes. Biopsy is essential for making a correct and prompt diagnosis. Treatment usually involves chemotherapy, but antiretroviral therapy may also have an important role. Infectious disease clinicians should be aware of this newly described and increasingly encountered lymphoma, since it is prominently associated with immunosuppression and may be mistaken for other entities.
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Affiliation(s)
- David J Riedel
- Division of Infectious Diseases and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Panos G, Karveli EA, Nikolatou O, Falagas ME. Prolonged survival of an HIV-infected patient with plasmablastic lymphoma of the oral cavity. Am J Hematol 2007; 82:761-5. [PMID: 17094093 DOI: 10.1002/ajh.20807] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Plasmablastic lymphoma is an aggressive subtype of diffuse large B-cell lymphoma that is mainly observed in patients with the human immunodeficiency virus (HIV) infection, and it tends to arise in the oral cavity. We present a case of an HIV-infected patient with plasmablastic lymphoma with prolonged survival. The 30-yr-old woman was found to have an oral lesion at the time of the diagnosis of HIV infection. Histological and immunochemical examination of biopsy of the oral lesion showed plasmablastic lymphoma (CD138+). She received two cycles of cyclophosphamide, vincristine, doxorubicin, and prednisolone (CHOP) that started 10 weeks after the initiation of antiretroviral therapy. The continuing pancytopenia and an adenoviral febrile infection did not permit further antineoplastic treatment. A gradual decrease of the oral lesion was noted after the second cycle of chemotherapy that led to the disappearance of the lesion 7 months later. The patient remains in complete remission 61 months after the diagnosis of plasmablastic lymphoma.
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Affiliation(s)
- George Panos
- HIV Unit, 2nd Internal Medicine Clinic, 1st IKA Hospital, Athens, Greece
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Kemp S, Gallagher G, Kabani S, Noonan V, O'Hara C. Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. ACTA ACUST UNITED AC 2007; 105:194-201. [PMID: 17604660 DOI: 10.1016/j.tripleo.2007.02.019] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Revised: 01/22/2007] [Accepted: 02/13/2007] [Indexed: 12/23/2022]
Abstract
Forty cases of oral cavity non-Hodgkin's lymphoma (NHL) were evaluated for sex, age, location, clinical presentation, and World Health Organization (WHO) histological subtype. Fifty-three percent were female and the mean age was 71. The upper jaw (maxilla or palatal bone), mandible, palatal soft tissue, and vestibule and gingivae (maxillary or mandibular soft tissue involvement only) were, respectively, the most common locations. Swelling, ulceration, and radiographic destruction of bone were the most frequent signs. Most of the lymphomas were of B cell lineage (98%), and the majority of these B cell lymphomas (58%) were histologically subtyped as diffuse large B cell lymphoma, which is considered to have an aggressive clinical course. An immunohistochemical panel was used in the majority of cases to confirm the lineage and to help characterize the subtype. B and T cell specific markers were used to show lineage of the neoplastic cells. Additional markers were used to help confirm specific subtypes that characteristically show specific positivity to some of these antibodies. Molecular studies to detect monoclonal immunoglobulin heavy chain (IgH) gene rearrangements and Bcl-1 and Bcl-2 gene translocations were performed in cases in which the diagnosis was in question. The current WHO classification is also reviewed in detail.
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Affiliation(s)
- Spencer Kemp
- Department of Oral and Maxillofacial Pathology, Boston University School of Dental Medicine, Boston, MA 02118, USA.
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Abstract
Plasmablastic lymphoma (PBL) is an uncommon, recently described B-cell-derived lymphoma that displays distinctive affinity for extranodal presentation in the oral cavity. Plasmablastic lymphoma is strongly associated with human immunodeficiency virus (HIV) infection, but has been reported in HIV-negative individuals. Plasmablastic lymphoma may be poorly recognized by pathologists, which is partly attributable to its relatively rare occurrence and unusual immunophenotype. Five cases of oral cavity lymphomas conforming to the current World Health Organization morphological criteria for PBL were retrieved from the consultation files at the Armed Forces Institute of Pathology. An immunohistochemical panel consisting of CD3, CD20, CD30, CD38, CD45RB, CD79a, CD138, Bcl-2, Bcl-6, Alk-1, Ki-67, EBV-LMP-1, and HHV8 was performed. All 5 cases were immunoreactive for CD38 and/or CD138, confirming plasma cell differentiation of the tumor cells. CD20 was immunoreactive in 1 case, and CD79a was positive in 2 cases. HHV8 and EBV-LMP-1 were nonreactive in all cases. Follow-up revealed only 1 patient alive with no evidence of disease. Our cases show that PBL is an aggressive type of B-cell lymphoma predominantly found in the oral cavity. Plasmablastic lymphoma is often associated with HIV infection.
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Affiliation(s)
- Gretchen S Folk
- Department of Oral and Maxillofacial Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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Epstein JB, Cabay RJ, Glick M. Oral malignancies in HIV disease: Changes in disease presentation, increasing understanding of molecular pathogenesis, and current management. ACTA ACUST UNITED AC 2005; 100:571-8. [PMID: 16243242 DOI: 10.1016/j.tripleo.2005.01.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Accepted: 01/10/2005] [Indexed: 11/19/2022]
Abstract
Infection with human immunodeficiency virus (HIV) and progression to acquired immune deficiency syndrome (AIDS) are associated with a vide variety of morbidities. Local and systemic diseases can develop in association with HIV infection and may manifest themselves as malignancies of the oropharynx. Advances in HIV management, fueled by increasing understanding of molecular pathogenesis, have resulted in marked changes in the prevalence of oral malignant disease. This paper discusses recent trends in the presentation and treatment of malignancies related to HIV and AIDS with an emphasis on malignancies seen in the oral cavity.
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MESH Headings
- Animals
- Antiretroviral Therapy, Highly Active
- Carcinoma, Squamous Cell/complications
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/therapy
- Carcinoma, Squamous Cell/virology
- DNA, Viral/analysis
- Developed Countries
- HIV Infections/complications
- HIV Infections/drug therapy
- Herpesvirus 4, Human/isolation & purification
- Humans
- Lymphoma, AIDS-Related/complications
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/therapy
- Mouth Neoplasms/complications
- Mouth Neoplasms/epidemiology
- Prevalence
- Sarcoma, Kaposi/complications
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/therapy
- United States/epidemiology
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Affiliation(s)
- Joel B Epstein
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, Chicago Cancer Center, University of Illinois at Chicago, IL 60612USA.
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Scheper MA, Nikitakis NG, Fernandes R, Gocke CD, Ord RA, Sauk JJ. Oral plasmablastic lymphoma in an HIV-negative patient: A case report and review of the literature. ACTA ACUST UNITED AC 2005; 100:198-206. [PMID: 16037778 DOI: 10.1016/j.tripleo.2004.11.050] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Plasmablastic lymphoma is an HIV-associated non-Hodgkin's lymphoma that primarily affects the oral cavity and jaws. The purpose of this report is to describe the first case of plasmablastic lymphoma occurring in an HIV-negative, nonimmunocompromised individual, and to review the histopathologic and immunohistochemical phenotype of this lymphoma. Histopathologically, our case exhibited a dense, diffuse lymphocytic infiltrate of noncohesive large lymphocytes with plasmacytoid features. Immunohistochemical analysis revealed positivity for the B-cell marker CD79a, VS38c, Epstein-Barr virus latent membrane protein (LMP), immunoglobulin G (IgG), and lambda light chain restriction. Neoplastic cells were negative for leukocyte common antigen, CD20, CD3, CD10, CD138, Bcl-2, Bcl-6, desmin, actin, EMA, S-100, HMB45, Alk-1, HHV8, IgA, IgM, and cytokeratin. The features of this rare disease are summarized based on a comprehensive review of the epidemiologic, clinical and immunohistochemical findings of previously reported cases.
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Affiliation(s)
- Mark A Scheper
- Department of Diagnostic Sciences and Pathology, University of Maryland Dental School, Baltimore, MD 21201, USA.
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21
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Teruya-Feldstein J, Chiao E, Filippa DA, Lin O, Comenzo R, Coleman M, Portlock C, Noy A. CD20-negative large-cell lymphoma with plasmablastic features: a clinically heterogenous spectrum in both HIV-positive and -negative patients. Ann Oncol 2005; 15:1673-9. [PMID: 15520070 DOI: 10.1093/annonc/mdh399] [Citation(s) in RCA: 147] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Plasmablastic lymphoma (PBL) has been described as a rapidly progressive and almost invariably fatal CD20- VS38c+ diffuse large-cell lymphoma with plasmablastic features, almost exclusively involving the jaw and oral mucosa in HIV-positive patients. METHODS From 2001 to 2003 we evaluated 12 men with PBL, and report the pathology, clinical findings, treatment and outcome. Six of 12 were HIV-positive while among the others, one was post-renal transplant, one had ulcerative colitis and four had no known immunodeficiency. RESULTS Tumor growth pattern, in general, showed cohesiveness and a starry-sky pattern; the morphology varied from typical plasmablastic to centroblastic cells. Partial immunophenotypes were (+/total): CD138, 11 of 12 (91.7%); MIB1 10 of 11 (4+, range 75-95%); p63/VS38c, nine of 10 (90%); EBV, eight of 11 (73%); LCA(CD45), two of 12 (16.7%); HHV8/LANA, zero of 10; ALK, zero of seven; and CD20, zero of 12. Three had stage IE and nine stage IV disease. Nine of 12 had an intermediate/high International Prognostic Index or high-risk disease. Computed tomography and positron emission tomography scan in four of 12 revealed extensive bone metastases. Eight of 12 are alive after treatment, with a median follow-up of 11+ months (range 1-24). Of the HIV-positive patients, five of six are alive with a median follow-up of 17 months. CONCLUSIONS It appears that PBL are heterogenous in terms of clinical presentation and morphology. The outcome presented here is superior to that originally reported.
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Affiliation(s)
- J Teruya-Feldstein
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, NY 10021, USA.
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22
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Lin O, Gerhard R, Zerbini MCN, Teruya-Feldstein J. Cytologic features of plasmablastic lymphoma. Cancer 2005; 105:139-44. [PMID: 15803491 DOI: 10.1002/cncr.21036] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Plasmablastic lymphomas (PBLs) were originally described exclusively in human immunodeficiency virus (HIV)-positive patients who presented with jaw or oral mucosa involvement. Recent studies have reported this neoplasm also in patients without HIV infection and involving sites other than head and neck. This lymphoma has a heterogeneous morphologic presentation but distinct phenotype. METHODS Cytologic features from four cases of histologically confirmed PBL were evaluated. The cytology specimens were evaluated for criteria as follow: cellularity, cell size and shape, pleomorphism, cytoplasmic characteristics, chromatin pattern, nucleolar features, and mitotic figures. RESULTS Specimens evaluated were two head and neck fine needle aspiration specimens, one anal smear, and one cerebrospinal fluid specimen. Atypical lymphocytes ranged from intermediate to large in size and demonstrated slight nuclear pleomorphism. The cytoplasm varied from scant to moderate in the alcohol-fixed slides. Nuclei were round with vesicular chromatin. Nucleoli varied from a prominent one to multiple small ones. Multinucleated cells and mitotic figures were easily identified in three of four cases. Tingible-body histiocytes were seen in one case. Ancillary studies in two cases demonstrated expression of CD138 with lack of CD20 expression. CONCLUSION PBL is a variant of large cell lymphoma with heterogeneous cytologic findings but distinct immunophenotype. Knowledge of the cytomorphologic spectrum of PBLs and detection of CD138 expression by flow cytometry can be helpful in achieving a correct diagnosis.
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Affiliation(s)
- Oscar Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
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23
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24
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Schichman SA, McClure R, Schaefer RF, Mehta P. HIV and plasmablastic lymphoma manifesting in sinus, testicles, and bones: a further expansion of the disease spectrum. Am J Hematol 2004; 77:291-5. [PMID: 15495247 DOI: 10.1002/ajh.20190] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patients with HIV infection are at increased risk for B-cell neoplasms and plasma cell dyscrasias. Both B cell and plasma cell tumors tend to be intermediate or high grade and are frequently associated with Epstein-Barr virus. Patients with HIV infection are also at higher risk of acquiring plasmablastic lymphoma. Until this time, only sinus, oral gastrointestinal, and lung manifestation have been noted. In this report we describe a 41-year-old male with HIV infection who developed multiple pleomorphic, extramedullary plasmablastic lymphomas associated with Epstein-Barr virus. We review the clinical and immunological features of his malignancy and thereby expand the spectrum of disease to include additional sites (bones, testicles) not previously reported.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Bone Neoplasms/immunology
- Bone Neoplasms/pathology
- Bone Neoplasms/virology
- Epstein-Barr Virus Infections/complications
- HIV Infections/complications
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Paranasal Sinus Neoplasms/immunology
- Paranasal Sinus Neoplasms/pathology
- Paranasal Sinus Neoplasms/ultrastructure
- Paranasal Sinus Neoplasms/virology
- Phenotype
- Testicular Neoplasms/immunology
- Testicular Neoplasms/pathology
- Testicular Neoplasms/virology
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Affiliation(s)
- Steven A Schichman
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
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25
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Abstract
PURPOSE OF REVIEW Infection with human immunodeficiency virus (HIV) is associated with an increased risk of non-Hodgkin lymphoma and Hodgkin disease. This review summarizes developments within the past 18 months. RECENT FINDINGS Investigators continue to demonstrate that many standard therapies similar to those used in the non-HIV- infected population may be used in the HAART era for patients infected with HIV. Biologic differences do exist, however, and not all treatments and outcomes are directly translatable. Some treatments, such as rituximab in combination with CHOP, may have unforeseen toxicity. Nonetheless, high-dose therapy does appear feasible and may offer curative therapy for those with refractory and relapsed disease. SUMMARY HIV-infected persons appear to benefit from most, but not all standard treatments for lymphoma.
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Affiliation(s)
- Ariela Noy
- Division of Hematology, Memorial Sloan-Kettering Cancer, Weill Medical College of Cornell University, New York, New York 10021, USA.
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26
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Lin F, Zhang K, Quiery AT, Prichard J, Schuerch C. Plasmablastic lymphoma of the cervical lymph nodes in a human immunodeficiency virus-negative patient: a case report and review of the literature. Arch Pathol Lab Med 2004; 128:581-4. [PMID: 15086296 DOI: 10.5858/2004-128-581-plotcl] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a case of plasmablastic lymphoma presenting in cervical lymph nodes in an 82-year-old, human immunodeficiency virus-negative man. Cytologic and histologic examinations demonstrated a large cell lymphoma with plasmacytic differentiation. The tumor cells were positive for CD138, CD38, epithelial membrane antigen, CD30, and lysozyme, but lacked expression of leukocyte common antigen, T-cell, and B-cell markers. Abundant Epstein-Barr virus-encoded RNA transcripts were identified by in situ hybridization. A monoclonal rearrangement of kappa-light- chain gene was demonstrated. The cytologic, histologic, immunohistochemical, and molecular features of plasmablastic lymphoma are reviewed. The potential diagnostic pitfalls and differential diagnoses, especially in a fine-needle aspiration specimen, are addressed.
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MESH Headings
- Aged
- Diagnosis, Differential
- Gene Rearrangement, B-Lymphocyte, Light Chain
- HIV Seronegativity
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunophenotyping
- In Situ Hybridization
- Lymph Nodes/pathology
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neck
- RNA, Viral/analysis
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Affiliation(s)
- Fan Lin
- Departments of Laboratory Medicine, Geisinger Medical Center, Danville, Pa 17822, USA.
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27
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Nasta SD, Carrum GM, Shahab I, Hanania NA, Udden MM. Regression of a plasmablastic lymphoma in a patient with HIV on highly active antiretroviral therapy. Leuk Lymphoma 2002; 43:423-6. [PMID: 11999580 DOI: 10.1080/10428190290006260] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We describe an HIV-infected 44-year-old man who presented 1 month after discontinuation of HAART therapy with a large mass extending from the mediastinum, enclosing the heart and extending through the diaphragm to the epigastric region. Biopsies subsequently revealed a highly aggressive non-Hodgkin's lymphoma (NHL) producing sheets of cells with an organoid distribution. The cells had abundant basophilic cytoplasm and a plasmacytic appearance. Although immunohistochemistry failed to show either B- or T-cell markers, antigens consistent with plasma cells were found. An immunoglobulin heavy chain clonal rearrangement was identified by PCR analysis. These studies were supportive of a diagnosis of a plasmablastic lymphoma. While awaiting the results of these tests, the patient was reinitiated on his HAART regimen. He was found on follow-up a month later to have complete resolution of his bulky mediastinal mass. He remained free of disease for 3 months with subsequent rectal and abdominal recurrence. Treatment with CHOP chemotherapy with filgrastim support was begun which resulted in another remission. Plasmablastic lymphoma is now reported in some studies to account for 2.6% of all HIV-related NHL. Originally described in 1997 in a series of 16 patients, this entity is highly associated with HIV infection in its later stages. Often, patients present with oral or jaw lesions with a rapidly progressive course. The tumors have the morphologic appearance of a plasmacytoid tumor with high proliferative index. Markers are positive mainly for LCA, CD79a, VS38C, and CD138. Co-infection with HHV-8 and EBV has not been consistently reported. Therapy with standard regimens has variable response. One case has been reported with a 3.5 year disease free survival. The regression of disease after resumption of HAART therapy alone in this patient suggests that HAART has an important role in the treatment of lymphoma in the HIV infected patient.
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MESH Headings
- Adult
- Anti-HIV Agents/administration & dosage
- HIV Infections/complications
- HIV Infections/drug therapy
- Humans
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/virology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Remission Induction
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Affiliation(s)
- Sunita D Nasta
- Division of Cancer Medicine, University of Texas M.D. Anderson Cancer Center, Houston, USA
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28
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Flaitz CM, Nichols CM, Walling DM, Hicks MJ. Plasmablastic lymphoma: an HIV-associated entity with primary oral manifestations. Oral Oncol 2002; 38:96-102. [PMID: 11755827 DOI: 10.1016/s1368-8375(01)00018-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Plasmablastic lymphoma is a relatively new entity that is considered to be a diffuse large B-cell lymphoma with an unique immunophenotype and a predilection for the oral cavity. We present a 50 year-old HIV-positive, bisexual, white male with a CD4 count 300/mm(3) and a viral HIV-RNA polymerase chain reaction (PCR) load of 237 copies/ml, who developed a painful, purple-red mass in the edentulous area of the maxillary right first molar. Erythematous gingival enlargements of the interdental papillae were seen in three of the dental quadrants. In addition, the patient was being managed with antiretroviral therapy and liposomal doxorubicin for recurrent cutaneous Kaposi's sarcoma (KS). Although oral KS was suspected, the gingival lesions were biopsied because they were refractory to chemotherapy and a lymphoma could not be excluded. Histopathologic examination revealed a lymphoid malignant neoplasm, consistent with a plasmablastic lymphoma. Immunoreactivity with vs38c, CD79a, kappa light chain, and IgG was readily identified in tumor cells; while only focal cells expressed CD20 and LCA (CD45RB). CD56, CD3, lambda light chain, and EMA were non-reactive. EBV was detected in the tumor by Southern hybridization, PCR amplification, in situ hybridization for EBER-1 DNA, and immunohistochemistry for latent membrane protein-1. The same tumor was negative for HHV-8 by PCR. Recognition of plasmablastic lymphoma is important, because it represents an HIV-associated malignancy that predominantly involves the oral cavity, may mimic KS and has a poor prognosis.
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Affiliation(s)
- C M Flaitz
- Department of Stomatology, University of Texas-Houston Health Science Center, Dental Branch, 6516 John Freeman Avenue, Houston, TX 77030, USA.
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29
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Robak T, Urbańska-Ryś H, Strzelecka B, Krykowski E, Bartkowiak J, Bĺoński JZ, Kordek R, Warzocha K. Plasmablastic lymphoma in a patient with chronic lymphocytic leukemia heavily pretreated with cladribine (2-CdA): an unusual variant of Richter's syndrome. Eur J Haematol 2001; 67:322-7. [PMID: 11872081 DOI: 10.1034/j.1600-0609.2001.00592.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Patients with chronic lymphocytic leukemia (CLL) may develop a large-cell transformation known as Richter's syndrome (RS). RS usually presents as diffuse large-cell lymphoma (DLCL) or its immunoblastic variant, and it can be recognized simultaneously with CLL or even 23 yr after its diagnosis. We describe an unusual case of CLL treated with cladribine (2-CdA) in whom DLCL of the plasmablastic type (PBL) developed 4 yr after CLL (Rai IV) diagnosis and 1.5 yr after the 10th course of 2-CdA treatment. Immmunologic, cytogenetic, and molecular studies performed at the time of CLL and PBL coappearance indicated that both tumors originated from different B-cell progenitors. Both malignancies were refractory to VAD (vincristine, doxorubicin, dexamethasone)-based chemotherapy, and only partial response was achieved with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) salvage treatment. However, the patient died 6 months after the occurrence of RS due to rapid progression of PBL. This is the first description of a CLL patient who developed an unusual plasmablastic variant of RS. Recently, the PBL entity has been identified among DLCL associated with the human immunodeficiency virus (HIV) infection. We suggest that in our CLL patient heavily pretreated with 2-CdA, PBL arose as a second clone due to the prolonged and severe state of the host's immunosuppression. Overall survival with current strategies is poor, and further insight into the natural history, biology, and treatment of PBL are needed.
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MESH Headings
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Cladribine/adverse effects
- Cladribine/therapeutic use
- Female
- Humans
- Immunosuppression Therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/chemically induced
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Middle Aged
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/etiology
- Plasma Cells/pathology
- Syndrome
- Time Factors
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Affiliation(s)
- T Robak
- Department of Hematology and Department of Oncology, Medical University of Lódź, Poland.
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30
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Kocjan G, Miller R. The cytology of HIV-induced immunosuppression. Changing pattern of disease in the era of highly active antiretroviral therapy. Cytopathology 2001; 12:281-96. [PMID: 11722508 DOI: 10.1046/j.1365-2303.2001.00331.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- G Kocjan
- Department of Histopathology, Royal Free and University College Medical School, University College London, UK
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31
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Cohen K, Scadden DT. Non-Hodgkin's lymphoma: pathogenesis, clinical presentation, and treatment. Cancer Treat Res 2001; 104:201-30. [PMID: 11191128 DOI: 10.1007/978-1-4615-1601-9_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- Antiviral Agents/therapeutic use
- Bleomycin/therapeutic use
- California
- Clinical Trials as Topic
- Combined Modality Therapy
- Cyclophosphamide/therapeutic use
- Dexamethasone/therapeutic use
- Doxorubicin/therapeutic use
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 8, Human/isolation & purification
- Homosexuality, Male
- Humans
- Infusions, Intravenous
- Lymphoma, B-Cell/pathology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, T-Cell/pathology
- Male
- Prognosis
- Registries
- Vincristine/therapeutic use
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Affiliation(s)
- K Cohen
- Massachusetts General Hospital, Dana-Farber/Harvard Cancer Center, Partners AIDS Research Center, Harvard Medical School, USA
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32
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Lin Y, Rodrigues GD, Turner JF, Vasef MA. Plasmablastic lymphoma of the lung: report of a unique case and review of the literature. Arch Pathol Lab Med 2001; 125:282-5. [PMID: 11175653 DOI: 10.5858/2001-125-0282-plotl] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Non-Hodgkin lymphomas associated with acquired immunodeficiency syndrome are heterogeneous. Recently, a novel subtype of non-Hodgkin lymphoma occurring mostly in patients with acquired immunodeficiency syndrome has been described and designated as plasmablastic lymphoma. The histomorphologic and immunophenotypic findings of this distinct subtype of non-Hodgkin lymphoma have been characterized previously. Most patients present with oral cavity involvement. We report a case of plasmablastic lymphoma presenting as a lung tumor. To our knowledge, this is the first case report of this unusual subtype of diffuse large B-cell lymphoma in this location.
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MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Antibodies, Monoclonal
- DNA, Viral/analysis
- Herpesvirus 4, Human/genetics
- Humans
- Immunohistochemistry
- Immunophenotyping
- In Situ Hybridization
- Lung Neoplasms/diagnosis
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Lung Neoplasms/virology
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Membrane Glycoproteins/analysis
- Middle Aged
- Plasma Cells/pathology
- Proteoglycans/analysis
- Syndecans
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Affiliation(s)
- Y Lin
- Department of Pathology, University of Iowa College of Medicine, Iowa City, USA
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