CD3 Positive Gastric Plasmablastic Lymphoma in A HIV Negative Patient: A Case Report

Abstract

Plasmablastic lymphoma is a rare and aggressive lymphoma characterized by the diffuse proliferation of large neoplastic cells resembling immunoblasts with an immunophenotype of plasma cells. A 47-year-old male was referred to our hospital with gastrointestinal bleeding, and a mass, 10 cm in diameter, was detected. An endoscopic biopsy was performed subsequently. A histopathological examination of the biopsy material revealed ulcer, alterations associated with ulcer, and further presented a diffuse infiltration of atypical cells with abundant cytoplasm and pleomorphic nuclei, some with crush artifacts in lamina propria. Immunohistochemically, the tumor cells were negative for cytokeratin, CD2, CD20, and PAX5; but they were positive for CD3, MUM1, CD38, and CD138. Ki67 proliferation index was as high as 95%. The case was signed out as CD3-positive plasmablastic lymphoma with clinical, histopathological, and immunohistochemical findings. The plasmablastic lymphoma case with an aberrant CD3 expression will be presented here, which is rarely observed in stomach.

Gastrointestinal Tract Plasmablastic Lymphoma in HIV-Infected Adults: A Histopathological Review

“…The majority of the gastrointestinal tract PBLs have been described in the stomach, small intestine, and colon as case reports and small case series. 18 -26 Herein, we report on 17 patients with gastrointestinal tract PBLs focusing on the morphological and immunohistochemical features.…”

“…8 The findings of the present study show comparable features to those reported in the case studies and series on gastrointestinal tract PBLs. 18 -26…”

“…The phenomenon of T-cell infidelity/promiscuity in which PBLs, which are B-cell lymphomas, express T-cell antigens is a well-recognized phenomenon. 18,41,42 CD3 expression in CD20+ B-cell lymphomas is usually not problematic since coexpression of these 2 markers will prompt further workup with more lineage-specific markers and B-cell and T-cell clonality studies. However, in cases where common B-cell antigens (CD20 and PAX5) are negative, T-cell infidelity may result in the classification of a tumor as a peripheral T-cell lymphoma, not otherwise specified (NOS).…”

“…Currently, studies available include few isolated cases and 2 case series of 4 cases each. 18 -26 Therefore, the current study aimed to comprehensively describe histopathological, immunophenotypical, and molecular features of gastrointestinal tract PBLs to improve on diagnostic accuracy and avoid inappropriate treatment.…”