A case of HIV‐negative plasmablastic lymphoma of the bone marrow with a unique immunophenotype

Abstract

Key Clinical MessageWe present an interesting case of plasmablastic lymphoma, which is a rare type of non‐Hodgkin lymphoma that is typically diagnosed in HIV‐positive patients and has an immunophenotype that overlaps with multiple myeloma. Our patient is unique because he is HIV‐negative, has primary bone marrow disease, and has an atypical immunophenotype.

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“…PBL has a characteristic immunophenotype, where in they are positive for the plasma cell markers such as CD38, CD138, and MUM1; and negative for the typical B-cell antigens such as CD20 and CD79 [6,9]. As the pathological examination of our case showed that CD38, CD138 and MUM1 markers were positive and CD20 and CD79 were negative.…”

“…Clinically, HIV-positive patients have a stronger male predominance, early lifetime onset, and classically manifest with EBV positive oral cavity lesions. Additionally, HIV-positive patients with PBL respond to antiretroviral medications and have improved overall survival [6].…”

“…Despite this opinion, comparative studies have shown that HIV status does not appear to affect the outcomes in PBL. In the literature, HIV-positive patients with PBL that added antiretroviral therapy seemed to do better to chemotherapy [6,7].…”

“…There is usually a high level of proliferation as detected by high Ki-67 levels in PBL.6We also determined in our case that Ki67 proliferation index was 80-90%. In two studies they suggested that Ki-67 values more than 80% have been seen to be an independent poor prognostic factor [6,10].…”

“…PBL has a clear male predominance, and the incidence rises in HIV-infected patients with decreased CD4 count [1]. We present an interesting case of plasmablastic lymphoma, which is a rare type of non-Hodgkin lymphoma (NHL) that is typically diagnosed in HIV-positive patients and has an immunophenotype that overlaps with multiple myeloma [6]. NHL and it is estimated incidence of PBL accounts for approximately 5% of all HIV-positive NHL cases.…”