Plasmablastic Lymphoma in a Previously Undiagnosed Human Immunodeficiency Virus-Positive Patient: A Case Report
Abstract
Plasmablastic lymphoma (PBL) is a rare and aggressive non-Hodgkin lymphoma subtype associated with human immunodeficiency virus (HIV) infection. PBL is extremely aggressive and has a poor response to treatment. Clinically PBL resembles a periodontal disease, Kaposi sarcoma, or melanoma. Delayed diagnosis adversely affects the treatment and life expectancy. A 52-year-old male presented with a firm intraoral mass causing a slight elevation noticeable extraorally. Radiologically, loss of lamina dura around the first premolar and loss of both vertical and horizontal bone height around the dental implant replacing the second premolar were present. The biopsy confirmed a diagnosis of PBL. Further evaluation revealed that the patient was positive for HIV. The chemotherapy regimen included etoposide, vincristine, hydroxydaunorubicin, cyclophosphamide, and prednisolone, followed by an autologous hematopoietic stem cell bone marrow transplant. This article attempts to describe the clinical presentation and histopathological evaluation of PBL, and emphasize the paramount role of biopsy, early clinical suspicion, and correct diagnosis.
Supporting Institution
None
Project Number
Not applicable
References
- Said J, Cesarman E, Rosenwald A, Harris NL. Lymphomas Associated with HIV Infection. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H et al. editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. France: International Agency for Research on Cancer; 2008. p. 451–452.
- Carbone A. AIDS-related non-Hodgkin’s lymphomas: from pathology and molecular pathogenesis to treatment. Hum Pathol 2002;33:392–404.
- 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. Lancet Infect Dis 2008;8:261–7.
- Delecluse HJ, Anagnostopoulos I, Dallenbach F, Hummel M, Marafioti T, Schneider U, et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood J Am Soc Hematol 1997;89:1413–20.
- Delecluse HJ, Feederle R, O’Sullivan B, Taniere P. Epstein–Barr virus-associated tumours: an update for the attention of the working pathologist. J Clin Pathol 2007;60:1358–64.
- Bagul N, Mamatha GS, Mahalle A. Plasmablastic Lymphoma of Gingiva Mimicking a Reactive Lesion: A Case Report. Case Rep Dent 2012;2012:1–4.
- Bhatt R, Desai DS. Plasmablastic Lymphoma. StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
- Yamada T, Kitamura N, Sasabe E, Yamamoto T, et al. Plasmablastic lymphoma of the upper gingiva in an HIV-negative elderly patient. Oral Maxillofac Surg Cases 2015;1:19–24.
- 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.
- Morscio J, Dierickx D, Nijs J, Verhoef G, Bittoun E, Vanoeteren X, et al. Clinicopathologic comparison of plasmablastic lymphoma in HIV-positive, immunocompetent, and posttransplant patients: single-center series of 25 cases and meta-analysis of 277 reported cases. Am J Surg Pathol 2014;38:875–86.
- Lopez A, Abrisqueta P. Plasmablastic lymphoma: current perspectives. Blood Lymphat Cancer Targets Ther 2018;8:63–70.
- Sapkota S, Priyadarshini M, Hazarika D, Swamy S, Naik R. Plasmablastic Lymphoma Involving Kidney in an HIV Positive Patient: A Case Report with Review of the Literature. Indian J Nephrol 2021;31:176–8.
- Fonseca FP, Robinson L, van Heerden MB, van Heerden WFP. Oral plasmablastic lymphoma: A clinicopathological study of 113 cases. J Oral Pathol Med 2021;50:594–602.
- Castillo JJ, Furman M, Beltrán BE, Bibas M, Bower M, Chen W, et al. Human immunodeficiency virus-associated plasmablastic lymphoma. Cancer 2012;118:5270–7.
- Rong C, Sheng L, Wu A, Sun Y, Ouyang G. Allogeneic hematopoietic stem cell transplantation in a patient with HIV-negative recurrent plasmablastic lymphoma. Medicine (Baltimore) 2021;100:e24498.
- Tchernonog E, Faurie P, Coppo P, Monjanel H, Bonnet A, Génin MA, et al. Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group. Ann Oncol 2017;28:843–8.
- Jayachandran PK, Rajan AK, Karunakaran P, Mehra N, Selvarajan G, Kesana S, et al. Plasmablastic lymphoma – single centre experience with infusional EPOCH chemotherapy. Leuk Res 2020;95:106391.
Daha Önce Tanı Almamış İnsan İmmünyetmezlik Virüsü Pozitif Hastada Plazmablastik Lenfoma: Bir Olgu Sunumu
Abstract
Plazmablastik lenfoma (PBL), insan immünyetmezlik virüsü (HIV) enfeksiyonu ile ilişkili nadir ve agresif bir Hodgkin-olmayan lenfoma (NHL) alt tipidir. PBL son derece agresif bir seyir gösterir ve tedaviye zayıf yanıt verir. Klinik olarak PBL; periodontal hastalık, Kaposi sarkomu veya melanomaya benzeyebilir. Geç tanı, tedaviyi ve yaşam beklentisini olumsuz etkiler. Bu olgu sunumu, sol maksillada hem bukkal hem de palatal tarafta premolar dişleri çevreleyen ve ekstraoral belirgin hafif bir yükselmeye neden olan sert hemisferik bir kitle şikayeti ile başvuran 52 yaşında erkek bir hastayı rapor etmektedir. Birinci premolar çevresinde lamina dura kaybına ve ikinci premoların yerini alan dental implant çevresinde hem dikey hem de yatay kemik yüksekliğinin kaybına ilişkin radyolojik kanıtlar izlenmiştir. Histolojik incelemede biyopsi örneği PBL tanısını doğrulamıştır. Daha sonraki değerlendirmede hastanın HIV pozitif olduğu ortaya çıkmıştır. Kemoterapi rejimi etoposid, vinkristin, hidroksidaunorubisin, siklofosfamid ve prednizolon (EPOCH) ve ardından otolog hematopoietik kök hücre kemik iliği naklini içermiştir. Bu makale PBL'nin klinik sunumunu ve şüpheli gingival büyümelerde biyopsi ve histopatolojik değerlendirmenin önemli rolünü vurgulamaya çalışmaktadır.
Project Number
Not applicable
References
- Said J, Cesarman E, Rosenwald A, Harris NL. Lymphomas Associated with HIV Infection. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H et al. editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. France: International Agency for Research on Cancer; 2008. p. 451–452.
- Carbone A. AIDS-related non-Hodgkin’s lymphomas: from pathology and molecular pathogenesis to treatment. Hum Pathol 2002;33:392–404.
- 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. Lancet Infect Dis 2008;8:261–7.
- Delecluse HJ, Anagnostopoulos I, Dallenbach F, Hummel M, Marafioti T, Schneider U, et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood J Am Soc Hematol 1997;89:1413–20.
- Delecluse HJ, Feederle R, O’Sullivan B, Taniere P. Epstein–Barr virus-associated tumours: an update for the attention of the working pathologist. J Clin Pathol 2007;60:1358–64.
- Bagul N, Mamatha GS, Mahalle A. Plasmablastic Lymphoma of Gingiva Mimicking a Reactive Lesion: A Case Report. Case Rep Dent 2012;2012:1–4.
- Bhatt R, Desai DS. Plasmablastic Lymphoma. StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
- Yamada T, Kitamura N, Sasabe E, Yamamoto T, et al. Plasmablastic lymphoma of the upper gingiva in an HIV-negative elderly patient. Oral Maxillofac Surg Cases 2015;1:19–24.
- 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.
- Morscio J, Dierickx D, Nijs J, Verhoef G, Bittoun E, Vanoeteren X, et al. Clinicopathologic comparison of plasmablastic lymphoma in HIV-positive, immunocompetent, and posttransplant patients: single-center series of 25 cases and meta-analysis of 277 reported cases. Am J Surg Pathol 2014;38:875–86.
- Lopez A, Abrisqueta P. Plasmablastic lymphoma: current perspectives. Blood Lymphat Cancer Targets Ther 2018;8:63–70.
- Sapkota S, Priyadarshini M, Hazarika D, Swamy S, Naik R. Plasmablastic Lymphoma Involving Kidney in an HIV Positive Patient: A Case Report with Review of the Literature. Indian J Nephrol 2021;31:176–8.
- Fonseca FP, Robinson L, van Heerden MB, van Heerden WFP. Oral plasmablastic lymphoma: A clinicopathological study of 113 cases. J Oral Pathol Med 2021;50:594–602.
- Castillo JJ, Furman M, Beltrán BE, Bibas M, Bower M, Chen W, et al. Human immunodeficiency virus-associated plasmablastic lymphoma. Cancer 2012;118:5270–7.
- Rong C, Sheng L, Wu A, Sun Y, Ouyang G. Allogeneic hematopoietic stem cell transplantation in a patient with HIV-negative recurrent plasmablastic lymphoma. Medicine (Baltimore) 2021;100:e24498.
- Tchernonog E, Faurie P, Coppo P, Monjanel H, Bonnet A, Génin MA, et al. Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group. Ann Oncol 2017;28:843–8.
- Jayachandran PK, Rajan AK, Karunakaran P, Mehra N, Selvarajan G, Kesana S, et al. Plasmablastic lymphoma – single centre experience with infusional EPOCH chemotherapy. Leuk Res 2020;95:106391.
Details
| Primary Language | English |
|---|---|
| Subjects | Dentistry |
| Journal Section | Case Report |
| Authors | |
| Project Number | Not applicable |
| Publication Date | September 4, 2023 |
| Published in Issue | Year 2023 Volume: 40 Issue: 3 |
