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Lv B, Yao M, Zhang W, Xiang F. Plasmablastic lymphoma with skin involvement in an immunocompetent male. Asian J Surg 2023; 46:5677-5678. [PMID: 37635027 DOI: 10.1016/j.asjsur.2023.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Baixue Lv
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging
| | - Mengyun Yao
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging
| | - Wen Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging.
| | - Feixiang Xiang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging.
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2
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Hyrcza MD, Lindenmuth TR, Auerbach A. Top Ten Lymphoproliferative Lesions Not to Miss When Evaluating Oral Ulcer Biopsies. Head Neck Pathol 2023; 17:99-118. [PMID: 36928739 PMCID: PMC10063747 DOI: 10.1007/s12105-023-01532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Oral ulcers represent a full thickness loss of the mucosal epithelium leading to exposure of the submucosal connective tissue. These are common and usually self-limited lesions, although they may sometimes result from neoplasms, most commonly squamous cell carcinoma. Lymphoproliferative disorders may be difficult to diagnose in apthous ulcers since they mimic reactive inflammation. METHODS This review presents ten rare oral lymphoid proliferations which should not be missed when assessing oral ulcer biopsies. RESULTS The ten lesions include several with diagnostic cells which look similar to the histiocytes of a reactive inflammatory ulcer, including Rosai-Dorfman disease, reticulohistiocytoma, Langerhans cell histiocytosis, and traumatic ulcerative granuloma. Other lesions, such as EBV-positive mucocutaneous ulcer, extranodal marginal zone lymphoma of mucosal-associated lymphoid tissue, and plasmablastic lymphoma have lymphoid and/or plasma cell differentiation that mimic the reactive lymphocytes and plasma cells found in reactive ulcers. Two dendritic cell lesions, follicular dendritic cell sarcoma and blastic plasmacytoid dendritic cell neoplasm, both have distinct phenotypes which are required to make an accurate diagnosis. CONCLUSION Each of these lesions are diagnosed by evaluating their histology, along with their phenotypic profile, which is sometimes enhanced by pertinent molecular findings.
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Affiliation(s)
- Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, AB Canada
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3
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Wen KW, Wang L, Menke JR, Damania B. Cancers associated with human gammaherpesviruses. FEBS J 2022; 289:7631-7669. [PMID: 34536980 PMCID: PMC9019786 DOI: 10.1111/febs.16206] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/10/2021] [Accepted: 09/16/2021] [Indexed: 01/14/2023]
Abstract
Epstein-Barr virus (EBV; human herpesvirus 4; HHV-4) and Kaposi sarcoma-associated herpesvirus (KSHV; human herpesvirus 8; HHV-8) are human gammaherpesviruses that have oncogenic properties. EBV is a lymphocryptovirus, whereas HHV-8/KSHV is a rhadinovirus. As lymphotropic viruses, EBV and KSHV are associated with several lymphoproliferative diseases or plasmacytic/plasmablastic neoplasms. Interestingly, these viruses can also infect epithelial cells causing carcinomas and, in the case of KSHV, endothelial cells, causing sarcoma. EBV is associated with Burkitt lymphoma, classic Hodgkin lymphoma, nasopharyngeal carcinoma, plasmablastic lymphoma, lymphomatoid granulomatosis, leiomyosarcoma, and subsets of diffuse large B-cell lymphoma, post-transplant lymphoproliferative disorder, and gastric carcinoma. KSHV is implicated in Kaposi sarcoma, primary effusion lymphoma, multicentric Castleman disease, and KSHV-positive diffuse large B-cell lymphoma. Pathogenesis by these two herpesviruses is intrinsically linked to viral proteins expressed during the lytic and latent lifecycles. This comprehensive review intends to provide an overview of the EBV and KSHV viral cycles, viral proteins that contribute to oncogenesis, and the current understanding of the pathogenesis and clinicopathology of their related neoplastic entities.
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Affiliation(s)
- Kwun Wah Wen
- Department of Pathology and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94158
| | - Linlin Wang
- Department of Laboratory Medicine, University of California, San Francisco, CA 94158
| | - Joshua R. Menke
- Department of Pathology, Stanford University, Palo Alto, CA 94304
| | - Blossom Damania
- Department of Microbiology & Immunology & Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599
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4
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Dubey H, Gupta S, Jha T, Tanwar K, Verma S, Ranjan A, Tanwar P. Therapy related complications in plasmablastic lymphoma in immunocompetent individual. AMERICAN JOURNAL OF BLOOD RESEARCH 2022; 12:168-171. [PMID: 36419572 PMCID: PMC9677181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Plasmablastic lymphoma (PBL) is a rare and aggressive subtype of diffuse large B-cell lymphoma seen in immunocompromised individuals. It has a diffuse growth pattern, with no standard therapy and a poor survival rate. Due to overlap in presenting features with lymphoma and myeloma, PBL is often a diagnostic dilemma. We present a case of PBL in a young immunocompetent female who developed treatment associated complications. CASE REPORT A 36-year-old presented with a lesion extending from the oral cavity to the pharynx and involving the angle of the mandible. Radiology and laryngoscopy described a growth pattern that was diagnosed to be PBL on histopathology. The patient underwent chemotherapy using level II DA-EPOCH (dose-adjusted-etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) and prophylactic granulocyte-colony stimulating factor along with radiotherapy and ultimately, achieved metabolic response. However, she developed several episodes of paralytic ileus, cytopenia, oral ulcers, dermatitis and long-standing hypothyroidism as therapy-related complications and has been on treatment for the same ever since. CONCLUSIONS Thus, a high index of suspicion is necessary for early diagnosis and rapid initiation of therapy. Further, there is a need to detect and address therapy related complications early to prevent long-standing, therapy-related side effects from developing and deteriorating the patient's quality of life.
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Affiliation(s)
- Harshita Dubey
- Laboratory Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew Delhi, India
| | - Swati Gupta
- Laboratory Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew Delhi, India
| | - Tanvi Jha
- Laboratory Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew Delhi, India
| | - Khushi Tanwar
- Indian Institute of Science Education and Research (IISR)Mohali, Punjab, India
| | - Saransh Verma
- All India Institute of Medical SciencesNew Delhi, India
| | - Amar Ranjan
- Laboratory Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew Delhi, India
| | - Pranay Tanwar
- Laboratory Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew Delhi, India
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5
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Scattered Violaceous Papules on the Trunk of an Adult Female: Answer. Am J Dermatopathol 2022; 44:230-231. [PMID: 35171887 DOI: 10.1097/dad.0000000000002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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AlMohamedi RS, AlRajban W, AlRikabi A, Arafah M. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac030. [PMID: 35186254 PMCID: PMC8853743 DOI: 10.1093/jscr/rjac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/16/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Waleed AlRajban
- Department of Pathology, King Khaled University Hospital, Riyadh, Saudi Arabia
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Ammar AlRikabi
- Department of Pathology, King Khaled University Hospital, Riyadh, Saudi Arabia
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Maha Arafah
- Department of Pathology, King Khaled University Hospital, Riyadh, Saudi Arabia
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
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Tajudeen M, Dutta S, Jain A, Srinivas BH, Nelamangala Ramakrishnaiah VP. A Rare Case of HIV-Associated Plasmablastic Lymphoma of Anal Canal. Cureus 2021; 13:e17782. [PMID: 34659993 PMCID: PMC8496561 DOI: 10.7759/cureus.17782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Plasmablastic lymphoma, an acquired immunodeficiency syndrome defining malignancy, is a subtype of diffuse large B-cell lymphoma. It is classically described in the oral cavity, the extraoral presentation being rare. Owing to its rarity and aggressiveness, plasmablastic lymphoma poses a diagnostic and therapeutic challenge to the treating physician. A 40-year-old male, recently diagnosed with HIV infection, presented with bleeding per rectum and spurious diarrhea. Examination revealed proliferative growth in the anal canal. Biopsy of the lesion was diagnostic of plasmablastic lymphoma. Computed tomography and magnetic resonance imaging were done to stage the lesion and assess the local extent, respectively. A multidisciplinary board discussion was done, and the patient was instituted on antiretroviral therapy and chemoradiotherapy. Following six cycles of chemotherapy and 25 fractions of radiotherapy, he achieved complete remission.
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Affiliation(s)
- Muhamed Tajudeen
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Souradeep Dutta
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Ankit Jain
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Silverstein J, Liu H, Shin D, Berler D. Plasmablastic Lymphoma Causing Adult Intussusception After Cardiac Transplantation. CRSLS : MIS CASE REPORTS FROM SLS 2021; 8:e2021.00069. [PMID: 36017063 PMCID: PMC9387386 DOI: 10.4293/crsls.2021.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intussusception in adults is a rare occurrence at approximately 5% and malignancy as the cause comprises half that number. The most common malignancies found are primary adenocarcinoma, metastatic carcinoma, lymphoma, and gastrointestinal stromal tumors. Lymphoma is the second most common. The management of adult intussusception is generally surgical, which is due to the higher likelihood of malignancy being the underlying cause. The patient's history helps to direct management and the most likely underlying diagnosis. This is especially important in patients who are immunosuppressed and with a history of lymphoproliferative disease. Early management and proper surgical intervention allow for the best survival rate. Here we present a case of adult intussusception caused by a rare and aggressive type of non-Hodgkin lymphoma.
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Affiliation(s)
| | - Helen Liu
- Surgery Department, NYU Langone - Long Island, Mineola, NY
| | - David Shin
- Surgery Department, NYU Langone - Long Island, Mineola, NY
| | - David Berler
- Staten Island University Hospital, Staten Island, NY
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9
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Nwanwene K, Khan NAJ, Alsharedi M. Testicular Plasmablastic Lymphoma in an HIV-Negative Patient: A Rare Case Presentation. J Investig Med High Impact Case Rep 2021; 9:23247096211017423. [PMID: 34032157 PMCID: PMC8155771 DOI: 10.1177/23247096211017423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is a very rare disease and it is usually considered a human
immunodeficiency virus (HIV)–related B-cell lymphoma that carries a poor prognosis. It
mostly involves the oral cavity, lungs, nasal cavity, gastrointestinal tract, lymph node,
and skin. Therapeutic regimens like dose-adjusted etoposide, vincristine, doxorubicin,
cyclophosphamide, and prednisone (DA-EPOCH) have shown better results in these aggressive
lymphomas. We report a rare case of PBL in an HIV-negative patient who presented to the
clinic with a complaint of left testicular swelling for 3 months. Ultrasound showed an
enlarged left testicle. He underwent a left orchiectomy and the pathology showed PBL with
involvement of the spermatic cord margin. Positron emission tomography scan showed
hypermetabolic mediastinal and hilar lymph nodes. He was started on DA-EPOCH but showed no
response. Accordingly, salvage therapy with bortezomib in addition to ifosfamide
carboplatin and etoposide (B-ICE) chemotherapy was initiated with remarkable response.
Several other regimens can be used in the refractory setting; however, the evidence is
mostly based on retrospective analysis.
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Li YJ, Li JW, Chen KL, Li J, Zhong MZ, Liu XL, Yi PY, Zhou H. HIV-negative plasmablastic lymphoma: report of 8 cases and a comprehensive review of 394 published cases. Blood Res 2020; 55:49-56. [PMID: 32269975 PMCID: PMC7106118 DOI: 10.5045/br.2020.55.1.49] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/06/2020] [Accepted: 03/07/2020] [Indexed: 12/22/2022] Open
Abstract
Background Human immunodeficiency virus (HIV)-negative plasmablastic lymphoma (PBL) is a rare entity of diffuse large B-cell lymphoma (DLBCL). The clinicopathological features of and optimal treatment for HIV-negative PBL remain largely unknown. Methods To gain insight into this distinct lymphoma, we summarized the clinicopathologic characteristics of 8 unpublished HIV-negative PBLs and performed a comprehensive review of 394 published cases. Results Of the 8 unpublished PBLs, the median patient age was 53.0 years. Four patients presented with stage IV disease. All 8 patients showed a plasma cell-like immunophenotype. Of the six patients who received anthracycline-based chemotherapy, including two who received bortezomib, three patients achieved a continuous complete response, two patients died due to disease progression, and one patient was lost to follow-up. The other two patients achieved continuous complete response after receiving chemotherapy combined with radiotherapy and surgery. Of the 402 patients, the majority were male, with a mean age of 58.0 years. EBV infection was detected in 55.7% of the patients. The median survival times of the patients who received CHOP or CHOP-like regimens and intensive regimens were not reached and 23.0 months, respectively, and the intensive regimen did not improve the survival outcome (P=0.981). Multivariate analysis showed that EBER remained the only independent factor affecting overall survival (OS). Conclusion HIV-negative PBL is a distinct entity with a predilection for elderly and immunosuppressed individuals. Intensive chemotherapy had no apparent survival benefits over the CHOP regimen in terms of OS; the prognosis of this disease is poor with current chemotherapy methods, and treatment remains a challenge.
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Affiliation(s)
- Ya-Jun Li
- Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, China.,Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ji-Wei Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Institute of Pathology, Fudan University, Shanghai, China
| | - Kai-Lin Chen
- Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Department of Radiotherapy, Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, China
| | - Jin Li
- Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, China.,Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Mei-Zuo Zhong
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Xian-Ling Liu
- Department of Oncology, Cancer Center of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Ping-Yong Yi
- Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, China.,Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Hui Zhou
- Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, China.,Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Mohd I, Gajbhiye SS, Verma R, Sardhara J. Solitary Primary Central Nervous System Plasmablastic Lymphoma in a Young Immunocompetent Female: Report on an Extremely Rare Entity with Review of Literature. Asian J Neurosurg 2019; 14:541-546. [PMID: 31143278 PMCID: PMC6515999 DOI: 10.4103/ajns.ajns_194_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Primary central nervous system (CNS) plasmablastic lymphoma (PBL) in immunocompetent patients is an extremely rare disease, and only three cases had been reported till date. We present a case of a young female of age 21 years immunocompetent human immunodeficiency virus (HIV) and Epstein–Barr virus (EBV) negative, presented to us with left frontal lesion with weakness of the right upper and lower limbs for 9 months. Magnetic resonance images showed ring-enhancing lesions resembling a cavernoma or tuberculoma. Histopathological diagnosis was PBL. Surgical excision of tumor, followed by rapid recurrence with bleed in 3-month duration, was treated by adjuvant chemoradiotherapy. We report a young immunocompetent, HIV-negative, and EBV-negative female, with rapidly progressive primary CNS solitary PBL in the posterior frontal region, developed rapid recurrence of the tumor twice despite gross total excision.
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Affiliation(s)
- Iqbal Mohd
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjog Shankar Gajbhiye
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ritu Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jayesh Sardhara
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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