Plasmablastic lymphoma of the stomach in an HIV‐negative patient

Abstract

Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm with an aggressive clinical behavior that predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients. However, it has recently been recognized that PBLs can also affect individuals without HIV infection, and suggested that these neoplasms show different clinicopathological characteristics between HIV-positive and -negative patients. Herein we describe a case of gastric PBL in a female HIV-negative patient. The tumor was composed of a diffuse and cohesive proliferation of large neoplastic cells, which resembled immunoblasts or plasmablasts with a starry sky appearance. Immunophenotypically, the neoplastic cells were diffusely positive for CD138, MUM1, IgM, and BOB-1, and negative for CK, LCA, CD3, CD20, CD79a, Pax5, kappa, lambda, CD30, ALK, S-100, HMB-45, MPO, and HHV-8. The MIB-1 index was nearly 100%. Epstein-Barr virus-encoded RNA in situ hybridization was negative. A monoclonal immunoglobulin heavy chain gene rearrangement was detected in polymerase chain reaction (PCR) and heteroduplex analyses. A combination of PCR-based analysis of immunoglobulin gene rearrangement and immunohistochemistry can be useful to substantiate the diagnosis by utilizing routine paraffin-embedded tissue sections, because PBL in the setting of extra-oral localization and immunocompetence is a diagnostic challenge, given its rarity, morphology, and absence of CD20 expression.

Unusual presentation of duodenal plasmablastic lymphoma in an immunocompetent patient: A case report and literature review

“…However, CD10 positivity indicated that the tumor may have stemmed from the germinal center, which is a common occurrence in PBL ( 1 ). Identification of the M protein appears to be unusual in patients with PBL, whereas monoclonal serum gammopathy has been observed in certain cases ( 12 , 13 ). IgM expression has been reported in a small minority of PBL cases, indicating that the M protein is not a strict discriminator ( 12 , 13 ).…”

Plasmablastic lymphoma as a rare cause of subocclusive events: Case report and review of the literature

“…Over one-third of all PBL cases were first noted at extraoral locations, predominantly within the gastrointestinal tract. According to the relevant literature, the HIVnegative patients can have PBL in the stomach, small bowel, and colon 6,9,10,13,14 . PBL of the small intestine is extremely rare.…”

“…Plasmablastic lymphoma (PBL), a rare subtype of diffuse large B cell lymphoma, usually occurs in the patients with HIV infection and is primarily found in the oral cavity [1][2][3][4] . There are also reported cases of PBL in the immunocompetent individuals involving the cervical lymph nodes, stomach, lungs, cavity, small and large bowel, and liver [5][6][7][8][9][10][11][12][13][14][15] . This rare lymphoproliferative disorder is characterized by its plasmablastic morphology and immunohistochemical panel.…”

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

“…Plasmablastic lymphoma is a rare and aggressive B-cell lymphoma firstly described in 1997 by Delecluse et al in the oral cavity of the immunocompromised patients [8]. In recent years, cases have been reported in HIV-negative patients, observed in the nasopharynx, maxillary sinus, orbita, skin, lung, gastrointestinal tract, soft tissue, anus, vulva, and mediastinum [1][2][3][4][5][6][9][10][11]. HIV positivity is seen in 90% of the oral PBL cases, whereas the HIV positivity in non-oral PBL cases is less prevalent.…”

“…Plasmablastic lymphoma (PBL) is a rare and aggressive B-cell lymphoproliferative disorder [1,2,3]. It is characterized by the diffuse proliferation of large neoplastic cells mainly resembling immunoblasts with an immunophenotype of plasma cells [1,4,5].…”