Cutaneous Plasmablastic Lymphoma in an Immunocompetent Patient with Long-Term Pyrimethamine Use for Essential Thrombocythemia: A Case Report and Literature Review

Abstract

We report a case of Epstein-Barr-virus-(EBV-) positive primary cutaneous plasmablastic lymphoma in a human-immunodeficiency-virus-(HIV-) negative, immunocompetent 62-year-old female patient. We postulate that her lymphoma development is due to the longstanding use of pyrimethamine for essential thrombocythemia. This has never been described in the literature.

Primary cutaneous lymphoma in southern Brazil: a 12‐year single‐center experience

“…A single case of plasmablastic lymphoma was detected in an HIV‐positive patient. This form is usually found in the context of HIV infection or other immunodeficiencies, although cases have been reported in immunocompetent and HIV‐negative patients …”

Immunosuppression-associated primary cutaneous plasmablastic lymphoma secondary to romidepsin

“…More aggressive disease was seen with large tumor size, multiple lesions, and advanced local disease with skin breakdown. Two cases had multiple risk factors yet achieved complete remission with systemic chemotherapy 4 , 7 . In our case, romidepsin was stopped, and the lesions were treated with local radiation therapy with disease remission.…”

“…Nineteen cases, including the current case, of pcPBL without systemic involvement have been reported 2, 3, 4, 5, 6, 7, 8, 9. The median age of onset is 56 (range, 32-85).…”

Plasmablastic lymphoma: a rare and exuberant cutaneous emergence in an immunocompetent patient

“…There are only around 20 reports of cutaneous involvement in post‐transplant HIV‐negative patients . The first cutaneous plasmablastic lymphoma in an HIV‐negative and immunocompetent patient was reported in 2013 and was considered by the authors of the report to have developed as a result of the long‐term use of pyrimethamine for essential thrombocythemia …”