A case of EBV-positive plasmablastic lymphoma in the mandibular gingiva of an elderly HIV-negative patient

Abstract

HANADA Hiroaki・KUROKAWA Yoshiya・FUJIWARA Shigeyoshi : Plasmablastic lymphoma (PBL) was first reported in 1997 as a non-Hodgkin' s lymphoma with a poor prognosis that occurred in the oral cavity of some human immunodeficiency virus (HIV)-positive patients. In 2008, it was added to the WHO classification as a type of aggressive B-cell lymphoma that can also occur in extranodal sites of elderly or immunocompromised patients. As half of the cases are related to Epstein-Barr virus (EBV) infection and categorized as EBV-associated lymphoproliferative disorders. We report a case of EBV-positive PBL that occurred in the mandibular gingiva of an HIV-negative patient. The patient was an 87-year-old man with a mass in the gingiva surrounding the second left mandibular molar. A biopsy revealed that the lesion was EBV-positive PBL. Serologically, HIV antibody was negative. The patient underwent radiation therapy (50 Gy) , which led to a completely positive response. After treatment, no recurrence was detected. Three years one month after treatment, dehydration led to a decrease in the level of consciousness and the resulting deterioration of general condition, and the patient died one month later. : plasmablastic lymphoma (形質芽細胞性リンパ腫) ， EBV-positive (EBV 陽性) ， mandibular gingiva(下顎 歯肉) ， radiation therapy (放射線療法) 姫路赤十字病院歯科口腔外科 (主任：藤原成祥部長) Department of Oral and Maxillofacial Surgery, Himeji Red Cross Hospital

Epstein–Barr Virus-Positive Mucocutaneous Ulcer: A Unique and Curious Disease Entity

“…Another study reported an EBVMCU case that resembled plasmablastic lymphoma (PBL) [ 56 ]. Furthermore, some studies have reported good prognoses among patients diagnosed with HIV-negative PBL [ 70 , 71 , 72 , 73 , 74 ]. Thus, some PBLs, especially HIV-negative cases, may be part of the morphological subtype of EBVMCU.…”

Epstein-Barr virus-positive mucocutaneous ulcer, plasmablastic type, associated with nodal CD4+ angioimmunoblastic T-cell lymphoma and generalised pruritus: a self-limiting lymphoproliferative disorder resembling cutaneous plasmablastic lymphoma

“…The relative frequency of EBV-MCU of plasmablastic type among EBV-MCU remains unknown. It is noteworthy that HIV-negative plasmablastic lymphoma in the elderly, often involving the nasal mucosa,24 tended to show a good prognosis 24–28. Plasmablastic lymphoma reported in HIV-negative elderly cases may be regarded as EBV-MCU of plasmablastic type.…”

“…The distinction between aggressive EBV-positive cutaneous lymphoma and EBV-MUC is often difficult by histopathologic evaluation alone 22 23. It is noteworthy that plasmablastic lymphoma in non-AIDS patients showed a good prognosis 24–28. It is highly likely that plasmablastic lymphoma reported in HIV-negative elderly cases can be categorised in EBV-MCU of plasmablastic type.…”