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DOI: 10.1055/s-0040-1721194
Plasmablastic Lymphoma: A Clinicopathological Study from a Tertiary Care Cancer Center in South India
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00049561/202002/lookinside/thumbnails/10-1055-s-0040-1721194_168_18-1.jpg)
Abstract
Background Plasmablastic lymphoma (PBL) is a rare aggressive B cell lymphoma that is commonly encountered in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). In this case series, we describe the clinicopathological features of cases of PBL seen at a tertiary care center in South India.
Materials and Methods Medical records of patients diagnosed with PBL between January 2009 and November 2017 were reviewed. PBL was defined as per the World Health Organization 2016 classification for hematopoietic and lymphoid neoplasms. The slides were reviewed with hematoxylin and eosin along with immunohistochemistry (IHC) including CD45, CD20, PAX5, CD79a, CD3, CD5, CD138, MUMI, EMA, ALK, and Ki67. Epstein-Barr virus (EBV) association was documented by rapid in situ hybridization (RISH) studies wherever possible. The demographic data, clinical presentation, treatment details, and outcomes are elaborated using descriptive statistics.
Results During the study period, nine patients with PBL were identified. The median age at presentation was 47 years (range: 36–54 years). All patients had associated HIV/AIDS, eight (89%) had extranodal disease, and six (66%) had advanced clinical stage (stage III). All biopsies were positive for CD45, CD138, and MUM1, and negative for CD79a and T cell markers with a high Ki67 proliferation index (85–90%); CD20 was faint positive in one patient, and CD56 was positive in one (11%) patient. EBV-RISH was tested in two patients and was positive in one. Bone marrow was uninvolved in all the cases. At the time of last follow-up, three patients were alive. Treatment details were available in six patients. With frontline therapy, four patients achieved a complete remission (CR) and one patient developed progressive disease. Three of four patients in CR are alive till the last follow-up.
Conclusion PBL is a rare form of lymphoma with predominant association with HIV, extranodal location, and characteristic IHC pattern.
Keywords
extranodal - human immunodeficiency virus association - immunohistochemistry - plasmablastic lymphomaPublication History
Article published online:
14 December 2020
© 2020. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Campo E, Stein H, Harris NL. Plasmablastic lymphoma. In: Swerdlow SH, Campo E, Harris NL. et al, eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Revised 4th ed. Lyon, France: IARC Press; 2017: 321-322
- 2 Delecluse HJ, Anagnostopoulos I, Dallenbach F. et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood 1997; 89 (04) 1413-1420
- 3 Castillo JJ, Bibas M, Miranda RN. The biology and treatment of plasmablastic lymphoma. Blood 2015; 125 (15) 2323-2330
- 4 Komaranchath AS, Haleshappa RA, Kuntegowdenahalli LC, Kumar RV, Dasappa L, Babu G. Plasmablastic lymphoma of the gastrointestinal tract: A rare entity with a dismal prognosis. Indian J Cancer 2016; 53 (04) 529-533
- 5 Reddy R, Gogia A, Kumar L. et al. HIV-associated hematologic malignancies: experience from a tertiary cancer center in India. Indian J Med Paediatr Oncol 2016; 37 (03) 141-145
- 6 Bishnu S, Banerjee S, Bandyopadhyay D, Samui S, Bhattacharya S, Bose D. Plasmablastic lymphoma in HIV patients: Experience at a tertiary care hospital in eastern India. Indian J Cancer 2015; 52 (04) 563-567
- 7 Babu KG, Suresh Babu MC, Abraham LJ. et al. Plasmablastic lymphoma: does prognosis differ with HIV status and site of disease?. Oncol Gastroenterol Hepatol Rep 2014; 3: 25-29
- 8 Hansra D, Montague N, Stefanovic A. et al. Oral and extraoral plasmablastic lymphoma: similarities and differences in clinicopathologic characteristics. Am J Clin Pathol 2010; 134 (05) 710-719
- 9 Cattaneo C, Re A, Ungari M. et al. Plasmablastic lymphoma among human immunodeficiency virus-positive patients: results of a single center’s experience. Leuk Lymphoma 2015; 56 (01) 267-269
- 10 Gujral S, Shet TM, Kane SV. Morphological spectrum of AIDS-related plasmablastic lymphomas. Indian J Pathol Microbiol 2008; 51 (01) 121-124
- 11 Montes-Moreno S, Gonzalez-Medina AR, Rodriguez-Pinilla SM. et al. Aggressive large B-cell lymphoma with plasma cell differentiation: immunohistochemical characterization of plasmablastic lymphoma and diffuse large B-cell lymphoma with partial plasmablastic phenotype. Haematologica 2010; 95 (08) 1342-1349
- 12 Vega F, Chang CC, Medeiros LJ. et al. Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles. Mod Pathol 2005; 18 (06) 806-815
- 13 Tchernonog E, Faurie P, Coppo P. et al. Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group. Ann Oncol 2017; 28 (04) 843-848