Extraoral plasmablastic lymphoma detected using ascitic fluid cytology and flow cytometry: a case report with a review of the literature

Plasmablastic Lymphoma in the Submandibular Region Diagnosed by FNAC: A Case Report and Literature Review

OBJECTIVE

This study aims to provide a literature review of FNAC-diagnosed plasmablastic lymphoma (PBL) cases and present a case of PBL in an HIV patient diagnosed by FNAC.

METHODS

A literature review was conducted across eight databases to compile information on FNAC-diagnosed PBL cases without restricting the site of involvement.

RESULTS

The literature review included 23 PBL, with 13 (56.5%) affecting head and neck region. The mean age of patients was 49 years, with a male-to-female ratio of 1.9:1, and 13 (56.5%) patients were HIV positive. Ten (43.5%) of 23 patients tested positive for Epstein-Barr virus (EBV). Twenty-one FNAC procedures and two cytological smears were performed. Plasmacytoid/plasmablastic morphology was described in seven cases (30.4%). Large cells were observed in 17 cases (73.9%). Pleomorphism was noted in 10 cases (43.5%). A cytological diagnosis of malignancy was achieved in 91.3% of cases. In 20 cases assessed for concordance, complete agreement was found in 8 cases (34.8%), while discordance was noted in 12 cases (65.2%). We also report a case of PBL diagnosed via FNAC in a 55-year-old male patient who presented with a painful, hard, nonmobile mass in the left submandibular region, approximately 10 cm in size, with 1 month of evolution. FNAC was performed, and cytologic smears, along with cell block (CB) preparations, were made. After staining with Diff-Quik, HE and Papanicolaou stain, numerous cells exhibiting plasmacytic morphology were observed. Immunohistochemical analysis showed negativity for LCA, CD3, CD20, Pax5, CD79a, ALK and HHV-8, and positivity for CD138, MUM1 and Ki-67 (100%). EBV positivity was also confirmed, leading to a diagnosis of PBL.

CONCLUSION

This study highlights the efficacy of FNAC in diagnosing PBL. The immunophenotypic profile and morphological features observed through FNAC, combined with immunohistochemistry (IHC) and in situ hybridisation, were crucial for an accurate diagnosis. The literature review underscores the value of FNAC as a diagnostic tool for PBL, demonstrating a high rate of cytological diagnosis and significant cytohistological concordance.

Human immunodeficiency virus-negative plasmablastic lymphoma: A case report and literature review

RATIONALE

Plasmablastic lymphoma (PBL) is a rare subtype of human immunodeficiency virus (HIV)-related non-Hodgkin's lymphoma that predominantly manifests in the oral cavity.

PATIENT CONCERNS

Three cases of HIV-negative PBL were reported.

DIAGNOSES

HIV-negative PBL INTERVENTIONS:: The patient had undergone chemotherapy.

OUTCOMES

Clinical outcomes were very poor in Cases 1 and 3; Case 2, whose diagnosis suggested no bone marrow involvement, is still alive.

LESSONS SUBSECTIONS

These cases served to broaden the reported clinical spectrum of HIV-negative PBL. Clinicians and pathologists need to be familiar with lymphoma in the identified extra-oral PBL variation and there levant differential diagnosis procedures for this particular disease.

HHV8/KSHV-Positive Lymphoproliferative Disorders and the Spectrum of Plasmablastic and Plasma Cell Neoplasms: 2015 SH/EAHP Workshop Report-Part 3

OBJECTIVES

The 2015 Workshop of the Society for Hematopathology/European Association for Haematopathology aimed to review immunodeficiency-related lymphoproliferative disorders with plasmablastic and plasma cell differentiation.

METHODS

The workshop panel reviewed human herpes virus 8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV)-associated lesions and other lesions exhibiting plasma cell differentiation, including plasmablastic proliferations with features of myeloma/plasmacytoma, plasmablastic neoplasms presenting in extranodal sites and effusion-based lymphomas, and rendered a consensus diagnosis.

RESULTS

The spectrum of HHV8/KSHV-associated proliferations ranged from multicentric Castleman disease (MCD) to MCD with plasmablastic aggregates to HHV8+ diffuse large B-cell lymphoma and germinotrophic lymphoproliferative disorder. Comparisons across effusion-based lymphomas with and without HHV8/KSHV and plasmablastic lymphomas in immunodeficient and immunocompetent patients were discussed.

CONCLUSIONS

The presence or absence of HHV8/KSHV is a defining feature in disorders associated with Castleman disease, although their differential diagnosis and recognition of progression may be challenging. Plasmablastic proliferations overlap with myeloma/plasmacytoma as well as extranodal and effusion-based lymphomas. The involvement of Epstein-Barr virus is typically variable.

Plasmablastic lymphoma exclusively involving bones mimicking osteosarcoma in an immunocompetent patient: A case report

BACKGROUND

It has been known that plasmablastic lymphoma (PBL) is a neoplasm of immunocompromised patients occurring in soft tissue of oral cavity or in the vicinity whereas bone is an unlikely site to harbor PBL. However, its occurrence is increasingly being reported in immunocompetent individuals in either osseous or extra-oral sites. To our best knowledge, F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient have not been reported, yet .

CASE SUMMARY

We report a case of PBL involving multiple bones in an immunocompetent patient. Features of different imaging modalities including F-18 Fluoro-deoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) were correlated well as findings of osteosarcoma in mandible with metastatic lesions. However, the histopathology and immunohistochemistry (IHC) of bone tissues from 2 separate biopsy sites revealed features of PBL.

CONCLUSION

awareness to F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient may prevent misdiagnosis.