Cytologic features of plasmablastic lymphoma

Abstract

Objective To analyze hematopoietic and immune reconstitution after autologous hematopoietic stem cell transplantation (HSCT) in 7 patients with systemic sclerosis (SSc). Methods Two groups of patients were retrospectively constituted according to whether they had a favorable clinical response (group A; n = 4) or no response or a relapse of disease (group B; n = 3) after HSCT. Immune reconstitution was analyzed every 3 months using lymphocyte immunophenotyping, α/β T cell receptor (TCR) diversity analysis, and ex vivo thymic function analysis by quantification of TCR rearrangement excision circles (TRECs). Results Patients had similar characteristics at study entry, except for a lower modified Rodnan skin thickness score (P = 0.03) and a lower Health Assessment Questionnaire score (P = 0.05) in group A than in group B. The number of reinjected cells and the time to hematopoietic reconstitution were similar in both groups. The absolute numbers of CD19+ and CD20+ B cells were lower in group A than in normal controls (P < 0.05) and within the normal range in group B. Absolute numbers of T and natural killer lymphocytes were normal before HSCT. Numbers of CD3+ cells remained low thereafter. Numbers of CD8+ cells were back to normal 3 months after HSCT in both groups. B cell counts were low until 6 months after HSCT in group A and stayed in the normal range in group B. The CD3+ defect was sustained in group A, with an opposite trend and a faster CD4+ reconstitution profile in group B. The T cell repertoire was skewed before and until 1 year after HSCT, with shared expansions before and after transplant in a given individual. TREC values correlated negatively with C‐reactive protein levels (rs = −0.41, P = 0.001) and positively with CD19+ (rs = 0.35, P = 0.001) and CD20+ (rs = 0.34, P = 0.002) lymphocyte counts. Conclusion B and T lymphocyte populations remained disturbed for at least 1 year after HSCT in SSc patients, which may reflect the persistence of an underlying disease mechanism.

HIV‐associated plasmablastic lymphoma: Lessons learned from 112 published cases

“…In the ensuing 10 years multiple case reports and case series [1,[24][25][26][27][28][29][30] of PBL in HIV-infected patients have served to expand our understanding of this novel lymphoma. We present, to the best of our knowledge, the first extensive literature review of the epidemiology, clinical findings, pathology, treatment, and outcome of 112 patients with HIV-associated PBL.…”

Plasmablastic lymphoma: Cytologic findings in 5 cases with unusual presentation

“…Plasmablastic lymphoma is a rare form of NHL that was once believed to occur primarily in HIV-positive individuals, [1][2][3][4][5][6] but more recently has been reported in HIV-negative patients. 1,7 It is defined by the World Health Organization (WHO) as a form of NHL characterized by plasma cell differentiation and immunoblastic morphology. 8 Initial reports of PBL in the HIV-positive population described primary oral involvement by an aggressive and locally invasive tumor that would frequently spread to distant extraoral sites.…”

“…2,9 Although these early reports suggested that presentation was mainly in the oral cavity, 2,4,5,10 several extraoral primary locations have more recently been described. These include the anus, 3,6,7 stomach, 7,11 colon, liver, 1,11 scrotum, 1 lung and pleura, 3,12 bone, and nasal and paranasal sinuses. 3,6,13,14 PBL is characterized histologically by cells with immature or blastoid morphology and a striking resemblance to immunoblasts.…”

Plasmablastic Lymphoma of Head and Neck: Report of Two New Cases and Correlation with c-myc and IgVH Gene Mutation Status

“…Immunophenotyping consistently shows strong CD138 and VS38c expression, variable expression of CD79a, EBER reactivity in the majority of cases, and absent or very weak expression of CD20 [1][2][3][4][5][6]. The clinical behavior has been reported as highly aggressive with generally poor response to therapy and short survival ranging between 1 and 28 months after diagnosis [1,4,9].…”

“…The neoplastic cells in PBL are generally blastic in appearance and show strong expression of plasma cellassociated antigens such as CD38 and CD138 and weak to absent expression of B-cell-associated markers CD20 and CD79a [1,[3][4][5][6]. The high-grade nature of this lymphoma is also represented by numerous interspersed ''tingible-body macrophages'', imparting a starry-sky appearance, and brisk mitotic activity [7].…”