A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with DisseminatedCryptococcus

Abstract

We present a case of a patient with HIV/AIDS who presented with a tender left lower extremity cutaneous mass over a site of previous cryptococcal infection and was found to have plasmablastic lymphoma (PBL). The incidence of PBL is estimated to account for less than 5% of all cases of non-Hodgkin lymphoma (NHL) in HIV-positive individuals. In fact, there were only two reports of extraoral PBL at the time of a 2003 review. PBL in HIV-positive individuals is an aggressive malignancy that tends to occur in middle-aged males with low CD4 counts, high viral loads, and chronic HIV infection. The definitive diagnosis can be made with biopsy which typically shows malignant lymphoid cells that stain positive for plasma cell markers and negative for B-cell markers. The most common treatment is chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens, but the overall survival rate is poor despite its relative responsiveness to chemotherapy. This case highlights the challenges that remain in improving clinical outcomes, the importance of antiretroviral therapy and HIV disease control, and a potential association between a chronic inflammatory state caused by disseminated Cryptococcus and tumorigenesis in individuals with PBL.

Unusual uterine metastasis of plasmablastic lenfoma: a case report

“…Hyper-CVAD, dose-adjusted EPOCH and CODOX-M/IVAC regimen is also used in PBL. Unfortunately aggressive regimens have not shown a statistically significant improvement in outcome and survival [2,3,8].…”

“…NHL and it is estimated incidence of PBL accounts for approximately 5% of all HIV-positive NHL cases. Incidence of HIVnegative PBL is still unclear [7,8]. With regard to the management of PBL, the common treatments are chemotherapy, radiotherapy with or without surgical excision, or the combination of chemotherapy and radiotherapy.…”

“…With regard to the management of PBL, the common treatments are chemotherapy, radiotherapy with or without surgical excision, or the combination of chemotherapy and radiotherapy. PBL has a poor prognosis and in the first year illness relapses at the rate of approximately 60% [ 8,9].…”

Plasmablastic-like lymphoma arising within chronic pyoderma gangrenosum

“…It is typically associated with HIV infection (CD4 + <200 cells/mm 3 ) where it presents as an ulcerating or necrotizing mass in the oral cavity 2 . Primary extranodal PBL may present as a polymorphous eruption on the skin 3, 4. Treatment includes CHOP or CHOP-like chemotherapy with possible adjuvant radiotherapy; however, prognosis is often poor 5 …”

Plasmablastic Lymphoma of Small Intestine: A Rare Case Report with Review of Literature

“…However, in recent years, several cases of PBL have been reported at extraoral sites, including the skin, [2] subcutaneous tissue, [3] stomach, [4] anal mucosa or perianal area [5], lung [6] lymph node [7], and other regions. Small intestine has rarely been reported as a site for PBL with only five cases [8][9][10][11][12] reported in the literature before, present case being the sixth case.…”