Korean J Hematol.  2009 Jun;44(2):122-126. 10.5045/kjh.2009.44.2.122.

Plasmablastic Lymphoma in a Human Immunodeficiency Virus-negative Patient: A Case Report and Review of the Literature

• Lim JH
• Joo WC
• Choi SJ
• Kim JS
• Yi HG
• Lee MH
• Lee JS
• Kim CS

• KMID: 2252159
• DOI: http://doi.org/10.5045/kjh.2009.44.2.122

Abstract

The plasmablastic lymphomas (PBLs) are an aggressive group of non-Hodgkin's lymphomas occurring primarily in human immunodeficiency virus (HIV)-infected individuals with absolute CD4 counts less than 200 per microliter. It was considered to be a diffuse large B-cell lymphoma with a unique immunophenotype and occurred primarily in the oral cavity. Recent studies report that PBLs also occur in patients without HIV infection. Herein we report an unusual case of plasmablastic lymphoma presenting in nasal cavity in a 74-year-old, HIV-negative woman. Cytologic and histologic examinations demonstrated a large cell lymphoma with plasmacytic differentiation. The tumor cells were positive for CD79a, CD38, however lacked expression of leukocyte common antigen, T-cell, and B-cell markers. Epstein-Barr virus-encoded RNA transcripts were identified by in situ hybridization. To our best knowledge, this is the second case of plasmablastic lymphoma in HIV-negative patient in Korea.

Keyword

Plasmablastic lymphoma; Human immunodeficiency virus; Epstein-Barr virus

MeSH Terms

Aged
Antigens, CD45
B-Lymphocytes
CD4 Lymphocyte Count
Female
Herpesvirus 4, Human
HIV
HIV Infections
Humans
In Situ Hybridization
Korea
Lymphoma
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Mouth
Nasal Cavity
RNA
T-Lymphocytes
Antigens, CD45
RNA

Figure

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  Fig. 1. This T2 weighted magnetic resonance imaging of the head shows ill defined heterogeneous mass of the maxillary sinus which extends to the left orbit inferior and medial wall.

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  Fig. 2. PET scan showing a focus of hypermetabolism in the mass of left maxillary sinus area.

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  Fig. 3. (A) Tumor cells had moderate amount of cytoplasm and eccentric nuclei with prominent nucleus (H&E stain ×400). (B) Immunohistochemical staining for CD38 is strongly positive in a diffuse fashion in nearly all tumor cells (CD38 stain ×100).

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  Fig. 4. Demonstration of Epstein-Barr virus encoded RNA (EBER) by in situ hybridization of Plasmablastic lymphoma cells.

Reference

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