Testicular Plasmablastic Lymphoma in an HIV-Negative Patient: A Rare Case Presentation

Abstract

Plasmablastic lymphoma (PBL) is a very rare disease and it is usually considered a human immunodeficiency virus (HIV)–related B-cell lymphoma that carries a poor prognosis. It mostly involves the oral cavity, lungs, nasal cavity, gastrointestinal tract, lymph node, and skin. Therapeutic regimens like dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone (DA-EPOCH) have shown better results in these aggressive lymphomas. We report a rare case of PBL in an HIV-negative patient who presented to the clinic with a complaint of left testicular swelling for 3 months. Ultrasound showed an enlarged left testicle. He underwent a left orchiectomy and the pathology showed PBL with involvement of the spermatic cord margin. Positron emission tomography scan showed hypermetabolic mediastinal and hilar lymph nodes. He was started on DA-EPOCH but showed no response. Accordingly, salvage therapy with bortezomib in addition to ifosfamide carboplatin and etoposide (B-ICE) chemotherapy was initiated with remarkable response. Several other regimens can be used in the refractory setting; however, the evidence is mostly based on retrospective analysis.

An Atypical Presentation of an Uncommon Malignancy: Plasmablastic Lymphoma Presenting As Recurrent Scrotal Abscesses

“…In our review of the literature via a search for "genitourinary plasmablastic lymphoma" on PubMed, only four cases of genitourinary PBL could be identified. These included two patients with testicular PBL, one patient with PBL of an uncircumcised penile prepuce, and an additional patient with PBL of the uterus [9][10][11][12]. Our patient's case is the first report of PBL manifesting as recurrent scrotal abscesses secondary to neoplastic infiltration of the scrotal wall.…”

Duodenal plasmablastic lymphoma in an human immunodeficency virus-negative patient: a case report

“…As a rare entity, PBL was originally described as a separate clinicopathologic entity by Delecluse et al as a rapidly proliferating B-cell lymphoma occurring in the oral cavity in the context of HIV infection [ 3 ]. Although the exact incidence of PBL is not known, it accounts for 2–3% of all AIDS-related lymphomas [ 1 ]. Furthermore, the majority of the cases reported arose in HIV-positive individuals, and in recent years, the occurrence of PBL in HIV-negative patients has been reported in escalating numbers [ 4 ].…”

“…Plasmablastic lymphoma (PBL) is a rare variant of diffuse large B-cell lymphoma (DLBCL) that is aggressive in nature and pathologically similar to plasma cell myeloma [ 1 ]. PBL was initially described in the oral cavity in patients with human immunodeficency virus (HIV) infection, but with improved awareness of the disease and a better understanding of its biology, PBL was subsequently identified in HIV negative individuals [ 2 ].…”

A Case Report of Plasmablastic Lymphoma with Unusual Presentation: How Do Socioeconomic Factors Contribute to Cancer Survival?

“…PBL is characterized by plasmablasts, which are lymphoid cells that have lost the characteristic B-cell surface markers and have instead acquired plasma cell surface markers (Nwanwene et al, 2021), its features overlap with myeloma and lymphoma making diagnosis difficult. Hence, PBL cells show plasmacytic differentiation markers-CD38, CD138, MUM1, Blimp1, XBP1, and MYC-with variable expression for CD45, CD79a, EMA, and CD30 (Pathak et al, 2021).…”