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Shruthi S, Kishan Prasad HL, Kanthaje A, Rajendra VKJ. Ovarian Plasmablastic Lymphoma Posing Diagnostic Dilemma: A Rare Case Report. J Obstet Gynaecol India 2023; 73:298-300. [PMID: 38143982 PMCID: PMC10746612 DOI: 10.1007/s13224-023-01802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/25/2023] [Indexed: 12/26/2023] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare, aggressive lymphoma with no definite standard of care with a poor outcome. It occurs predominantly in HIV-infected individuals and is frequently seen in extranodal sites. The important differential diagnosis for this PBL is plasmablastic myeloma, where clinical and histopathological features are often ambiguous, rendering the correct diagnosis difficult without complete integration of clinical, morphological, phenotypic, and molecular features. Here, we report a rare case of plasmablastic lymphoma of the ovary with a diagnostic dilemma and the approach to the diagnosis and its management.
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Affiliation(s)
- Shruthi Shruthi
- Department of Pathology, Nitte (Deemed to be University), KS Hegde Medical Academy, Deralakatte, Mangalore, Karnataka 575018 India
| | - H. L. Kishan Prasad
- Department of Pathology, Nitte (Deemed to be University), KS Hegde Medical Academy, Deralakatte, Mangalore, Karnataka 575018 India
| | - Apoorva Kanthaje
- Department of Pathology, Nitte (Deemed to be University), KS Hegde Medical Academy, Deralakatte, Mangalore, Karnataka 575018 India
| | - Vinay Kumar J. Rajendra
- Department of Surgery, Nitte (Deemed to be University), KS Hegde Medical Academy, Deralakatte, Mangalore, Karnataka 575018 India
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2
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Tsutsumi Y, Kitano S, Yanagita S, Tachibana M. Epstein-Barr virus-positive mucocutaneous ulcer, plasmablastic type, associated with nodal CD4+ angioimmunoblastic T-cell lymphoma and generalised pruritus: a self-limiting lymphoproliferative disorder resembling cutaneous plasmablastic lymphoma. BMJ Case Rep 2022; 15:e247430. [PMID: 35523507 PMCID: PMC9083435 DOI: 10.1136/bcr-2021-247430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2022] [Indexed: 12/16/2022] Open
Abstract
A woman in her 80s reported of generalised pruritus, which was treated with phototherapy and steroid administration. Two months after onset, lymph node biopsy revealed CD4+ angioimmunoblastic T-cell lymphoma with systemic superficial nodal involvement. Intractable prurigo was judged as T-cell lymphoma related. After effective chemotherapy (7 months later), skin nodules appeared multifocally, including on the lip, thumb and lower leg. The biopsied infiltrative lesion on the right lower leg microscopically revealed subcutaneous growth of atypical plasmablasts with nearly 100% Ki-67 labelling and Epstein-Barr virus (EBV)-encoded small nuclear RNA positivity. Plasmablastic lymphoma (CD45/CD19/CD38/CD138/MUM1+, CD20/CD79a/PAX5-) was suspected. Immunoglobulin light-chain restriction and nuclear expression of c-myc protein were undetectable, and the ulcers were spontaneously epithelialised by the cessation of steroid administration. After 10 months, non-progressive prurigos persisted on the extremities, but without regrowth of nodal T-cell lymphoma and cutaneous lymphoproliferative lesion. Reactive nature of the EBV-induced mucocutaneous plasmablastic growth (EBV-positive mucocutaneous ulcer, plasmablastic type) is discussed.
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Affiliation(s)
- Yutaka Tsutsumi
- Division of Diagnostic Pathology, Tsutsumi Byori Shindanka Clinic, Inazawa, Aichi, Japan
- Department of Medical Technology, Yokkaichi Nursing and Medical Care University, Yokkaichi, Mie, Japan
| | - Seiya Kitano
- Department of Dermatology, Shimada General Medical Center, Shimada, Shizuoka, Japan
| | - Soshi Yanagita
- Department of Hematology, Shimada General Medical Center, Shimada, Shizuoka, Japan
| | - Mitsuhiro Tachibana
- Department of Diagnostic Pathology, Shimada General Medical Center, Shimada, Shizuoka, Japan
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3
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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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4
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Elyamany G, Fouly A, Alqahtani A, Alrumeh A, Asiri S, Faifi SA, Alshieban S. Cytological Diagnosis of Plasmablastic Lymphoma Involving the Parotid Gland: A Case Report with Review of the Literature. Case Rep Oncol 2021; 14:244-248. [PMID: 33776711 PMCID: PMC7983620 DOI: 10.1159/000509746] [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] [Received: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/19/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare subtype of non-Hodgkin's lymphoma that is associated with acquired immunodeficiency syndrome (AIDS), characterized by its association with Epstein-Barr virus (EBV), aggressive nature, and plasmacytic/plasmablastic differentiation. PBL remains a therapeutic and diagnostic challenge. Diagnosis of PBL by fine-needle aspiration cytology (FNAC) is reported infrequently. We herein describe the cytodiagnosis of a rare case of HIV-negative PBL in a 58-year-old man without EBV infection presented by parotid swelling. The current case study highlights the cytomorphologic features that may help to distinguish PBL from other mimics. However, although the cytomorphologic features may suggest PBL, a definitive diagnosis requires additional studies including tissue biopsy and immunohistochemistry, in addition to biochemical investigations and radiological workup to establish the diagnosis and exclude similar conditions. In conclusion, FNAC is a very useful, simple, rapid and reliable procedure for diagnosis of the lymphoma. FNAC provided the earliest clue to diagnosis of PBL, which was later confirmed by tissue biopsy.
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Affiliation(s)
- Ghaleb Elyamany
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahmed Fouly
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulmalik Alqahtani
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Assem Alrumeh
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Shuaa Asiri
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Salman Ali Faifi
- Department of Pathology and Laboratory Medicine, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saeed Alshieban
- Department of Pathology and Laboratory Medicine, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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5
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Plasmablastic neoplasms with unusual histomorphology: A report of two cases. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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6
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Tissir R, Rais H, Tazi I. [Isolated plasmablastic lymphoma of nasal mucosa in an immunocompetent patient achieving complete remission after multimodal treatment: about an African patient and literature review]. Pan Afr Med J 2020; 37:22. [PMID: 33062124 PMCID: PMC7532850 DOI: 10.11604/pamj.2020.37.22.21352] [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] [Received: 12/19/2019] [Accepted: 07/13/2020] [Indexed: 12/30/2022] Open
Abstract
Plasmablastic lymphoma is an aggressive variant of lymphomas recently distinct from diffuse large B cell lymphoma. It has been initially described as a disease affecting the oral cavity of immunocompromised patients. We here report the first case of a 54-year-old patient with nasal septum nodule, bleeding on contact and after sneezing which occurred 6 months before admission. Facial computed tomography (CT) scan showed thickening of the nasal mucosa of 14mm. Excisional biopsy showed tumor proliferation composed of plasmablastic cells with immunophenotypic features: CD 138+, ki67 80%, EMA+, CD79a+, CD 56+. Staging and HIV serology were negative. Given the rarity of this lymphoma there are no standard treatments and most patients have treatment-resistant lymphoma with poor prognosis. Our patient received 6 cycles of CHOP-like chemotherapy associated with 40 gy radiotherapy in 20 fractions of 2 gy with complete remission (unusual in the cases described in the literature).
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Affiliation(s)
- Rajaa Tissir
- Service d'Hématologie, CHU Mohammed VI, Université Cadi Ayyad, Marrakech, Maroc
| | - Hanan Rais
- Service d'Anatomopathologie, CHU Mohammed VI, Université Cadi Ayyad, Marrakech, Maroc
| | - Ilyas Tazi
- Service d'Hématologie, CHU Mohammed VI, Université Cadi Ayyad, Marrakech, Maroc
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7
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Vera G, Cordova P, Sepulveda G, Benavides T, Astorga F, Gonzalez W. Plasmablastic lymphoma as a manifestation of the human immunodeficiency virus: Case report. J Clin Exp Dent 2020; 12:e429-e432. [PMID: 32382394 PMCID: PMC7195680 DOI: 10.4317/jced.56482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/27/2020] [Indexed: 11/09/2022] Open
Abstract
Plasmablastic lymphoma is a rare subtype of non-Hodgkin’s lymphoma, which generally presents an aggressive clinical course and low survival rates. It is strongly associated with HIV infection and the most common site of involvement of the territory of the head and neck is Waldeyer’s lymphatic ring, followed by the gastrointestinal tract, lymph nodes and skin. The morphological characteristics of PBL in the oral cavity / jaw in the context of HIV infection show diffuse sheets of large immunoblastic cells with abundant cytoplasm, vesicular chromatin and prominent nucleus, a small located in the center with plasma cells differentiation. The main goal of this article is to review the literature of the plasmablastic lymphoma and report a case. Key words:Plasmablastic lymphoma, PBL, HIV, AIDS, Non Hodgkin Lynphoma.
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Affiliation(s)
- Gonzalo Vera
- Residente de Cirugía maxilofacial, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo Cordova
- Cirujano Maxilofacial, Universidad de Valparaíso, Valparaíso, Chile.,Hospital El Carmen Dr. Luis Valentin Ferrada, Maipú, Chile
| | | | | | - Felipe Astorga
- Hospital El Carmen Dr. Luis Valentin Ferrada, Maipú, Chile
| | - Wilfredo Gonzalez
- Hospital El Carmen Dr. Luis Valentin Ferrada, Maipú, Chile.,Centro de Investigación en Ciencias Odontológicas y Médicas, Facultad de Odontología, universidad de Valparaíso, Valparaíso, Chile
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Meer S, Perner Y, McAlpine ED, Willem P. Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area. Histopathology 2019; 76:212-221. [PMID: 31361906 DOI: 10.1111/his.13964] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/29/2019] [Indexed: 11/29/2022]
Abstract
AIMS Plasmablastic lymphoma (PBL) occurs mainly in immunocompromised individuals, usually secondary to human immunodeficiency virus (HIV) infection. It classically occurs intraorally, but has been described in extraoral locations. The aim of this study was to define the immunophenotype and Epstein-Barr virus (EBV) status in a large single-centre cohort of extraoral PBL (EPBL) in South Africa, a high-prevalence HIV setting. METHODS AND RESULTS This retrospective study of 45 EPBLs included patients' age, gender, race, HIV status, and site. Cases were reviewed histologically, and classified morphologically as pure plasmablastic or plasmablastic with plasmacytic differentiation, and assessed immunohistochemically with antibodies against CD45, CD20, CD79a, PAX5, CD138, MUM1/IRF4, BLIMP1, VS38c, Ki67, bcl-6, CD10, cyclin D1, and human herpesvirus-8, by the use of standard automated procedures. EBV was assessed by the use of chromogenic in-situ hybridisation. Tumours were assessed with a fluorescence in-situ hybridisation (FISH) MYC break-apart probe. Twenty-seven PBLs showed pure plasmablastic morphology, and 18 showed plasmacytic differentiation. The male/female ratio was 1.5:1. The anus was the favoured extraoral site (31.1%), followed by lymph nodes (15.6%). All 29 patients with known HIV status were HIV-positive. The immunohistochemical profile recapitulated that reported for oral PBLs and EPBLs in HIV-positive and HIV-negative patients. EBV was positive in 92.5% of PBLs. FISH analysis showed MYC rearrangement in 48% of cases. CONCLUSION This study showed a strong association of EPBLs with HIV and EBV infection, similarly to the previously described oral PBL. The strong EBV association together with other clinicopathological parameters and an immunohistochemical profile that includes CD45, CD20, MUM1/IRF4, CD138 and Ki67 may be used in distinguishing PBL from diffuse large B-cell lymphoma and plasma cell myeloma.
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Affiliation(s)
- Shabnum Meer
- Department of Oral Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yvonne Perner
- Department of Anatomical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ewen D McAlpine
- Department of Anatomical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pascale Willem
- Department of Hematology and Molecular Medicine, Somatic Cell Genetics Unit, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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9
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Miao L, Guo N, Feng Y, Rao H, Wang F, Huang Q, Huang Y. High incidence of MYC rearrangement in human immunodeficiency virus-positive plasmablastic lymphoma. Histopathology 2019; 76:201-211. [PMID: 31348551 DOI: 10.1111/his.13959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/23/2019] [Indexed: 01/12/2023]
Abstract
AIMS MYC rearrangements are the main cytogenetic alterations in plasmablastic lymphoma (PBL). We aimed to investigate the relationship between MYC rearrangement and the clinicopathological features of PBL. METHODS AND RESULTS MYC rearrangements assessed in 13 unpublished single-centre PBL cases, and an additional 85 cases from the literature, with reported MYC rearrangement information individualised by patient, were reviewed. In Asia, PBL was much less commonly diagnosed in human immunodeficiency virus (HIV)-positive patients (27% versus 84%, P = 0.000), with older age (median age at diagnosis: 52 years versus 44 years, P = 0.046) and a lower EBV infection rate (56.8% versus 81.8%, P = 0.049), than in non-Asian regions. Overall, MYC rearrangements were identified in 44 of 98 (44.9%) PBL cases, and IGH was the partner in almost all available cases (30/31, 96.8%), as confirmed with a MYC-IGH fusion probe. The MYC rearrangement rate in HIV-positive cases (33/55, 60.0%) was significantly higher than that in HIV-negative cases (11/38, 28.9%, P = 0.003). Patients with MYC rearrangement showed a trend towards an inferior median survival time (9.6 months versus 15.7 months, P = 0.122) and 2-year overall survival (17% versus 32%, P = 0.238). CONCLUSIONS MYC rearrangement was frequently identified in PBL patients, and IGH was the partner gene in an overwhelming majority of MYC rearrangements. In addition, the MYC rearrangement rate was significantly higher in HIV-positive PBL patients than that in HIV-negative patients. MYC rearrangement may play an important role in the pathogenesis of HIV-positive PBL, but further studies are required to understand the underlying mechanisms.
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Affiliation(s)
- Lanfang Miao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China.,Department of Pathology, Anyang Tumour Hospital, Anyang, China
| | - Na Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Yanfen Feng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Huilan Rao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Fang Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Molecular Diagnosis, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Qitao Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Yuhua Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Centre, Guangzhou, China
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Plasmablastic Lymphoma, a Rare Entity in Bone Marrow with Unusual Immunophenotype and Challenging Differential Diagnosis. Case Rep Hematol 2019; 2019:1586328. [PMID: 31565447 PMCID: PMC6745100 DOI: 10.1155/2019/1586328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 07/08/2019] [Accepted: 08/14/2019] [Indexed: 01/22/2023] Open
Abstract
Plasmablastic lymphoma (PBL) is an aggressive malignancy that usually occurs in the setting of immunosuppression. The immunohistochemical profile of PBL is that of terminally differentiated B lymphocytes. CD138, CD38, and MUM1 are usually immunopositive. However, pan B-cell markers such as CD20 and PAX-5 are usually negative. MYC rearrangement is the most commonly encountered genetic alteration, with immunoglobulin (IG), especially immunoglobulin heavy (IGH) chain, being the most frequent partner. We report a case of PBL in a 48-year-old human immunodeficiency virus- (HIV-) positive male who was admitted to the hospital with signs and symptoms suspicious for tumor lysis syndrome. Bone marrow examination revealed hypercellular marrow with trilineage hypoplasia and sheets of intermediate to large neoplastic cells with basophilic vacuolated cytoplasm comprising the majority of cellular elements of the bone marrow. The neoplastic cells were negative for conventional B-cell, T-cell, plasma cell, and myeloid markers, while flow cytometric analysis revealed an abnormal CD45-dim population that was partially weakly positive for CD71 and CD79b. The diagnosis was initially thought to be a high-grade primitive hematopoietic neoplasm, possibly an acute undifferentiated leukemia. BOB-1, however, was immunopositive in the neoplastic cells, confirming its B-cell origin. MYC was positive by immunohistochemistry and break-apart FISH, as were CD45, MUM-1, and EMA immunostains. There was immunoglobulin kappa (IGK) light chain gene rearrangement by polymerase chain reaction (PCR). Additionally, Epstein–Barr virus- (EBV–) encoded small RNAs (EBER) were positive by in situ hybridization (ISH). The tumor proliferation index by Ki-67 immunostaining approached 95%. Although the tumor cells were negative for CD38 and CD138, the diagnosis of PBL was still rendered. We recommend using a broad spectrum of B-cell markers, including BOB-1 and OCT-2, in such challenging cases of B-cell lymphomas with no expression of conventional B-cell markers. We also emphasize that the negative CD38 and CD138 should not exclude PBL from the differential diagnosis.
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Alvarez E, Gunther M, Hernández P, Misad C, Fernandez MÁ, Donoso-Hofer F. Revisión sistemática del linfoma plasmablástico intraoral en paciente con virus de la inmunodeficiencia humana. A propósito de un caso. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.maxilo.2017.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Milićević A, Nikolić J, Mihailović D, Janić J, Mihailović M. NASOPHARYNGEAL PLASMABLASTIC LYMPHOMA: A CASE REPORT. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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13
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Monohan G. Plasmablastic Myeloma versus Plasmablastic Lymphoma: Different Yet Related Diseases. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/htij.2018.06.00146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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14
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Liu Z, Fang Q, Zhou S, Minhas V, Wood C, He N, Zhang T. Seroprevalence of Kaposi's sarcoma-associated herpesvirus among HIV-infected Uygurs in Xinjiang, China. J Med Virol 2017; 89:1629-1635. [PMID: 28252177 PMCID: PMC9995688 DOI: 10.1002/jmv.24804] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/15/2017] [Indexed: 12/25/2022]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) is the etiological agent of Kaposi's sarcoma (KS), which primarily affects human immunodeficiency virus (HIV)-infected adults with advanced immunodeficiency. Xinjiang province in China is an endemic area for Kaposi's sarcoma (KS), however, currently, only limited data for KSHV infection among HIV-infected individuals living in this endemic area is available. A cross-sectional study of 86 HIV positive participants was conducted in Xinjiang, China from 2014 through 2015. Plasma samples were collected and screened for KSHV and HIV infection. HIV pol gene and KSHV ORF-K1 gene were amplified and sequenced, genotypes were determined by phylogenetic analysis. Over all, prevalence was 48.9% (42/86; 95%CI 38.4-59.3%) for KSHV. Only CRF07_BC subtype has been identified among all these HIV positive individuals, while the subtype A and C of KSHV were detected in the participants. Meanwhile, we found that those with high CD4 counts (>500) showed a lower anti-KSHV titer, compared with other groups. Our study indicated a high prevalence of KSHV among HIV positive individuals in Xinjiang, China. Thus, management of HIV/AIDS patients should include KSHV screen and should consider the risk of KSHV-associated malignancies.
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Affiliation(s)
- Zhenqiu Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Qiwen Fang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Sujuan Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Veenu Minhas
- Nebraska Center of Virology and the School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Charles Wood
- Nebraska Center of Virology and the School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
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15
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Plasmablastic Lymphoma Mimicking Acute Pancreatitis. Case Rep Oncol Med 2016; 2016:9751736. [PMID: 27034868 PMCID: PMC4808524 DOI: 10.1155/2016/9751736] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 12/22/2015] [Indexed: 12/22/2022] Open
Abstract
Background. Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior. Case Presentation. We describe an unusual case of a 37-year-old HIV-positive male who presented with acute pancreatitis secondary to multiple peripancreatic masses compressing the pancreas. Histopathological examination of the lesions showed diffuse and cohesive pattern of large B-cells resembling immunoblasts or plasmablasts. The neoplastic cells were positive for BOB1 and MUM1, partially positive for CD79a, and negative for CD20, CD56, CD138, CD3, CD5, AE1/AE3, and HHV8. Epstein-Barr virus-encoded RNA in situ hybridization was positive. These features were consistent with PBL. The patient was initiated on cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy, demonstrating a striking response. Conclusion. To our research, this is the first report of PBL with the initial presentation of acute pancreatitis. The findings in this case suggest that PBL should be included in the differential diagnosis of pancreatic and peripancreatic tumors.
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16
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Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions. Adv Hematol 2015; 2015:315289. [PMID: 26357515 PMCID: PMC4555447 DOI: 10.1155/2015/315289] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 07/29/2015] [Accepted: 08/03/2015] [Indexed: 12/16/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is an aggressive subtype of non-Hodgkin's lymphoma (NHL), which frequently arises in the oral cavity of human immunodeficiency virus (HIV) infected patients. PBL shows diffuse proliferation of large neoplastic cells resembling B-immunoblasts/plasmablasts, or with plasmacytic features and an immunophenotype of plasma cells. PBL remains a diagnostic challenge due to its peculiar morphology and an immunohistochemical profile similar to plasma cell myeloma (PCM). PBL is also a therapeutic challenge with a clinical course characterized by a high rate of relapse and death. There is no standard chemotherapy protocol for treatment of PBL. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC), or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) are possible options. Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients. The introduction of genes encoding artificial receptors called chimeric antigen receptors (CARs) and CAR-modified T cells targeted to the B cell-specific CD19 antigen have demonstrated promising results in multiple early clinical trials. The aim of this paper is to review the recent advances in epidemiology; pathophysiology; clinical, pathologic, and molecular characteristics; therapy; and outcome in patients with PBL.
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