A Rare Case of Plasmablastic Lymphoma in a Patient with HIV and SARS-CoV-2 Infections

Abstract

Lesions commonly associated with HIV infection include oral candidiasis, herpes simplex infection, oral Kaposi’s sarcoma, hairy leukoplakia, periodontal diseases (linear gingival erythema and necrotizing ulcerative periodontitis), xerostomia, human papillomavirus-associated warts, aphthous ulcers, non-Hodgkin’s lymphoma, histoplasmosis, carcinoma, exfoliative cheilitis, and HIV salivary gland disease. Non-Hodgkin’s lymphoma (NHL) is the most common cancer in people living with HIV (PLWH), and the incidence is increased for aggressive B-cell NHL. Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy that is often unresponsive to chemotherapy and usually has a poor prognosis. We hereby present the case of a patient with a recent history of COVID-19 infection who was diagnosed with HIV and NHL, with manifestations in the oral cavity and a favorable evolution after the introduction of antiviral therapy, specific chemotherapy, and radiotherapy. Dental expertise is necessary for the appropriate management of oral manifestations of HIV infection or AIDS, and lymphoma should be included in the differential diagnosis of any oral lesions.

The Oral Lesion in the COVID-19 Patient: Is It True Oral Manifestation or Not?

“…The underlying disease frequently reported was diabetes mellitus, 84 , 87 , 91 , 92 , 94 , 95 , 107 , 115 , 129 hypertension, 70 , 82 , 84 , 87 , 90 , 92 , 94 , 95 , 100 , 107 , 108 , 115 stroke, 100 obesity, 47 , 84 , 92 , 107 CVD, 82 , 121 , 129 hypothyroidism, 92 , 108 , 129 COPD, 92 , 100 , 107 carcinoma, 92 , 107 renal disease 92 , 107 and cardiac disease. 10 Other conditions such as rheumatoid arthritis, 91 allergies, 94 chronic sinusitis, 70 coronary and peripheral artery disease, 92 vascular disease, 91 hypercholesterinemia, 121 hyperlipidemia, 92 pancreatitis, 107 Parkinson's disease, 107 peripheral neuropathy, 91 rectal tumour, 108 HIV, 78 depression, 91 follicular lymphoma, 125 kidney transplant 82 and autosomal dominant polycystic kidney disease 82 were also reported ( Table 15 ).…”

“… 10 Other conditions such as rheumatoid arthritis, 91 allergies, 94 chronic sinusitis, 70 coronary and peripheral artery disease, 92 vascular disease, 91 hypercholesterinemia, 121 hyperlipidemia, 92 pancreatitis, 107 Parkinson's disease, 107 peripheral neuropathy, 91 rectal tumour, 108 HIV, 78 depression, 91 follicular lymphoma, 125 kidney transplant 82 and autosomal dominant polycystic kidney disease 82 were also reported ( Table 15 ).…”

“…Most of the prescribed drug was antibiotics, 47 , 70 , 82 , 87 , 90 , 91 , 107 , 108 , 115 , 121 , 125 , 129 anti-coagulant, 47 , 82 , 91 , 107 anti-viral, 78 , 92 , 100 , 115 NSAIDs, 70 , 90 steroid, 47 , 90 , 92 , 100 , 107 , 125 anti-diabetic, 94 , 95 anti-hypertension, 94 , 95 or cardiac drug, 10 anti-malaria, 82 , 125 anti-allergic, 94 and bronchodilator. 70 Another study only mentions intensive care medicine 84 and covalent plasma administration.…”

“…The oral lesion was ulcer, 47 , 78 , 82 , 87 , 92 , 100 , 107 , 108 , 115 , 121 , 125 papula-plaque, 82 , 90 , 125 , 129 pseudomembrane, 92 , 94 , 129 crust, 84 , 100 , 107 , 108 erosion, 94 , 125 hemorrhagic, 95 , 107 depapilation, 10 ecchymosis, 94 macula, 90 vesicle 70 and white patches. 91 The location of the lesion dominated in the tongue, 10 , 82 , 87 , 91 , 92 , 94 , 107 , 115 , 129 lip, 47 , 70 , 84 , 94 , 100 , 107 , 108 palate 90 , 91 , 94 , 95 , 129 and labial 91 , 92 , 100 , 125 ( Table 15 ).…”

Manifestaciones orales por COVID-19

“…Existe reporte de enfermedad periodontal necrotizante por coinfecciones bacterianas (especialmente Prevotella intermedia) junto con COVID-19 en pacientes jóvenes en donde la encía además de presentar inflamación generalizada, presenta eritema difuso y necrosis en la zona Inter papilar (30)(31)(32) .…”