Plasmablastic lymphoma exclusively involving bones mimicking osteosarcoma in an immunocompetent patient

Abstract

Background:It has been known that plasmablastic lymphoma (PBL) is a neoplasm of immunocompromised patients occurring in soft tissue of oral cavity or in the vicinity whereas bone is an unlikely site to harbor PBL. However, its occurrence is increasingly being reported in immunocompetent individuals in either osseous or extra-oral sites. To our best knowledge, F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient have not been reported, yet .Case summary:We report a case of PBL involving multiple bones in an immunocompetent patient. Features of different imaging modalities including F-18 Fluoro-deoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) were correlated well as findings of osteosarcoma in mandible with metastatic lesions. However, the histopathology and immunohistochemistry (IHC) of bone tissues from 2 separate biopsy sites revealed features of PBL.Conclusion:awareness to F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient may prevent misdiagnosis.

Radiological features of oral and maxillofacial plasmablastic lymphomas

“…The extensive nature of PBL cases often results in multiple regions being frequently involved, with infiltration into adjacent structures being a common finding. The findings of involvement of multiple regions have also been reported in the literature [5,20]. Consistent with the literature, a predilection for the oral region was also noted in the current study [13].…”

Human Immunodeficiency Virus Associated Plasmablastic Lymphoma Involving Bones and Peritoneum in a 4-Year-old Child

“…Another prognostic factor that has emerged is the presence of MYC gains or translocations, which has been noted to adversely impact survival and specifically in HIV-positive PBL 5,7. FDG-PET, an optimal staging modality in PBL picked up clinically unrecognizable bony sites and peritoneal disease in our case 8,9. As is the case with other HIV-related malignancies, instituting early HAART forms the cornerstone of this malignancy as well.…”

“…5,7 FDG-PET, an optimal staging modality in PBL picked up clinically unrecognizable bony sites and peritoneal disease in our case. 8,9 As is the case with other HIV-related malignancies, instituting early HAART forms the cornerstone of this malignancy as well. Therapy of pediatric PBL is two-pronged, employing both HAART and multi-agent chemotherapy in tandem.…”

Human immunodeficiency virus (HIV)-negative uterine plasmablastic lymphoma on 18F-FDG PET/CT

“…A few cases of PBL using 18 F-FDG PET/CT scan have been reported in the literature. 3 – 7 To the best of our knowledge, this is the first case to report PBL of uterus using 18 F-FDG PET/CT scan.…”