A Case of Plasmablastic Lymphoma in an Immunocompetent Individual

Authors

  • Rekha Bansal DNB Resident, Department of Medical Oncology, Omega Hospitals, Hyderabad
  • P. Satya Dattatreya Senior Medical Oncologist, Omega Hospitals, Hyderabad, India

DOI:

https://doi.org/10.15379/2408-9877.2019.06.01.02

Keywords:

Plasmablastic lymphoma, Immunocompetent, Extraoral disease, Non-Hodgkin’s lymphomas, B-cell lymphoma

Abstract

Introduction: Plasmablastic Lymphoma, a subtype of Diffuse large B-cell lymphoma is known to occur in association with HIV infection. We report a case of extraoral plasmablastic lymphoma at an unusual site.

Case presentation: 66 years old male patient was evaluated in view of persistent headache and proptosis. He was found to have a frontal mass lesion extending into the orbit. Pathology and IHC confirmed it to be Plasmablastic Lymphoma. He received treatment with DA-R-EPOCH with bortezomib to which he responded extremely well and remains disease free for more than 12 months.

Conclusion: Despite being an aggressive lymphoma with poor prognosis, our patient responded extremely well to the treatment.

References

Stein H, Harris NL, Campo E. Plasmablastic lymphoma. In: Swerdlow SH, Campo E, Harris NL, et al. eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon, France: IARC Press. World Health Organization Classification of Tumours; 2008; 2: 256-257.

Thakral, Charu, et al. "Plasmablastic lymphoma in an immunocompetent patient." Journal of Clinical Oncology 2009; 27(25): e78-e81. https://doi.org/10.1200/JCO.2009.22.2208

Loghavi, Sanam, et al. "Stage, age, and EBV status impact outcomes of plasmablastic lymphoma patients: a clinicopathologic analysis of 61 patients." Journal of hematology & oncology 2015; 8(1): 65. https://doi.org/10.1186/s13045-015-0163-z

Castillo J, Pantanowitz L, Bezube BJ. HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83(10): 804-809 https://doi.org/10.1002/ajh.21250

Raviele PR, Pruneri G, Maiorano E. Plasmablastic lymphoma: a review. Oral Diseases 2009; 15: 38-45 https://doi.org/10.1111/j.1601-0825.2008.01493.x

Pruneri G, Graziadei G, Ermellino L, Baldini L, Neri A, Buffa R. Plasmablastic lymphoma of the stomach; a case report. Haematologica. 1998; 83(1): 87-89.

Folk GS, Abbondanzo SL, Childers EL, et al. Plasmablastic lymphoma: A clinicopathologic correlation. Ann Diagn Pathol 2006; 10: 8-12. https://doi.org/10.1016/j.anndiagpath.2005.07.009

Castillo, Jorge J., Michele Bibas, and Roberto N. Miranda. "The biology and treatment of plasmablastic lymphoma." Blood 2015; 125(15): 2323-2330. https://doi.org/10.1182/blood-2014-10-567479

Colomo L, Loong F, Rives S, Pittaluga S, Martinez A, Loopen-Guillermo A, Ojanguren J et al. Diffue large B-cell lymphoma with plasmablastic differentiation represent a heterogeneous group of disease entities. Am J Surg Pathol 2004; 28: 736-747 https://doi.org/10.1097/01.pas.0000126781.87158.e3

Scheper MA, Nikitakis NG, Fernandes R, Gocke CD, Ord RA, Sauk JJ. Oral plasmablastic lymphoma in an HIV-negative patient: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2005; 100: 198-206 https://doi.org/10.1016/j.tripleo.2004.11.050

Valenzuela AA, Walker NJ, Sullivan TJ. Plasmablastic lymphoma in the orbit: case report. Orbi 2008; 27: 227-229 https://doi.org/10.1080/01676830802014150

Castillo JJ, Winer ES, Stachurski D, et al. Clinical and pathological differences between human immunodeficiency virus-positive and human immunodeficiency virus-negative patients with plasmablastic lymphoma. Leuk Lymphoma 2010; 51: 2047-2053. https://doi.org/10.3109/10428194.2010.516040

Morscio J, Dierickx D, Nijs J, 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(7): 875-886. https://doi.org/10.1097/PAS.0000000000000234

LIu, MIn, et al. "Human immunodeficiency virus-negative plasmablastic lymphoma: A comprehensive analysis of 114 cases." Oncology reports 2015; 33(4): 1615-1620. https://doi.org/10.3892/or.2015.3808

Vega F, Chang CC, Medeiros LJ, et al. Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles. Mod Pathol 2005; 18(6): 806-815 https://doi.org/10.1038/modpathol.3800355

Guidelines Version NCCN. 4. 2014. AIDS-Related B-Cell Lymphomas. http://www.nccn.org/ professionals/physician_gls/pdf/nhl.pdf. Accessed September 18, 2014.

Wilson WH, Dunleavy K, Pittaluga S, et al. Phase II study of dose-adjusted EPOCH and rituximab in untreated diffuse large B-cell lymphoma with analysis of germinal center and post-germinal center biomarkers. J Clin Oncol 2008; 26(16): 2717-2724. https://doi.org/10.1200/JCO.2007.13.1391

Magrath I, Adde M, Shad A, et al. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 1996; 14(3): 925-934. https://doi.org/10.1200/JCO.1996.14.3.925

Cortes J, Thomas D, Rios A, et al. Hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone and highly active antiretroviral therapy for patients with acquired immunodeficiency syndrome-related Burkitt lymphoma/leukemia. Cancer. 2002; 94(5): 1492-1499. https://doi.org/10.1002/cncr.10365

Castillo J, Pantanowitz L, Dezube BJ. HIV associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83(10): 804-809. https://doi.org/10.1002/ajh.21250

Castillo JJ, Winer ES, Stachurski D, et al. HIV negative plasmablastic lymphoma: not in the mouth. Clin Lymphoma Myeloma Leuk 2011; 11(2): 185-189. https://doi.org/10.1016/j.clml.2011.03.008

Castillo J, Pantanowitz L, Dezube BJ. HIV associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83(10): 804-809. https://doi.org/10.1002/ajh.21250

Castillo JJ, Winer ES, Stachurski D, et al. HIV negative plasmablastic lymphoma: not in the mouth. Clin Lymphoma Myeloma Leuk 2011; 11(2): 185-189. https://doi.org/10.1016/j.clml.2011.03.008

Klapproth K, Wirth T. Advances in the understanding of MYC-induced lymphomagenesis. Br J Haematol 2010; 149(4): 484-497. https://doi.org/10.1111/j.1365-2141.2010.08159.x

Simonitsch-Klupp I, Hauser I, Ott G, et al. Diffuse large B-cell lymphomas with plasmablastic plasmacytoid features are associated with TP53 deletions and poor clinical outcome. Leukemia 2004; 18(1): 146-155. https://doi.org/10.1038/sj.leu.2403206

Published

2019-01-30

Issue

Section

Articles