Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area

Abstract

Aims Plasmablastic lymphoma (PBL) occurs mainly in immunocompromised individuals, usually secondary to human immunodeficiency virus (HIV) infection. It classically occurs intraorally, but has been described in extraoral locations. The aim of this study was to define the immunophenotype and Epstein–Barr virus (EBV) status in a large single‐centre cohort of extraoral PBL (EPBL) in South Africa, a high‐prevalence HIV setting. Methods and results This retrospective study of 45 EPBLs included patients' age, gender, race, HIV status, and site. Cases were reviewed histologically, and classified morphologically as pure plasmablastic or plasmablastic with plasmacytic differentiation, and assessed immunohistochemically with antibodies against CD45, CD20, CD79a, PAX5, CD138, MUM1/IRF4, BLIMP1, VS38c, Ki67, bcl‐6, CD10, cyclin D1, and human herpesvirus‐8, by the use of standard automated procedures. EBV was assessed by the use of chromogenic in‐situ hybridisation. Tumours were assessed with a fluorescence in‐situ hybridisation (FISH) MYC break‐apart probe. Twenty‐seven PBLs showed pure plasmablastic morphology, and 18 showed plasmacytic differentiation. The male/female ratio was 1.5:1. The anus was the favoured extraoral site (31.1%), followed by lymph nodes (15.6%). All 29 patients with known HIV status were HIV‐positive. The immunohistochemical profile recapitulated that reported for oral PBLs and EPBLs in HIV‐positive and HIV‐negative patients. EBV was positive in 92.5% of PBLs. FISH analysis showed MYC rearrangement in 48% of cases. Conclusion This study showed a strong association of EPBLs with HIV and EBV infection, similarly to the previously described oral PBL. The strong EBV association together with other clinicopathological parameters and an immunohistochemical profile that includes CD45, CD20, MUM1/IRF4, CD138 and Ki67 may be used in distinguishing PBL from diffuse large B‐cell lymphoma and plasma cell myeloma.

Epstein barr virus encodes miRNAs to assist host immune escape

“…However, in a recent study of miRNA sequencing in PBL, it was found that EBV also had type II latency in PBL patients and expressed LMP1, suggesting that the latency state of EBV in tumor is not constant, and the change of latency may be related to immune regulation of EBV [24]. PBL patients are often associated with HIV and EBV infection [25,26]. HIV infection has long been considered as the main cause of PBL, while EBV infection has not received much attention.…”

Genomic Characterization of HIV-Associated Plasmablastic Lymphoma Identifies Pervasive Mutations in the JAK–STAT Pathway

“…For targeted sequencing (n = 95 samples; extension cohort), formalin-fixed paraffin-embedded (FFPE) material was retrieved from the archives of the Department of Oral Pathology and Anatomical Pathology, National Health Laboratory Service and the University of the Witwatersrand. This panel included 36 nonoral PBL samples that were part of a published cohort (52). The study protocol was approved by the local Human Research Ethics Committee (IRB Reference M150390).…”

The genetic structure and adaptation of Andean highlanders and Amazonian dwellers is influenced by the interplay between geography and culture

“…The second highest signal (that also shows a significant long-range haplotype signal) comes from the region around the gene PTPRC , which encodes the protein CD45, essential in antigen recognition by T and B lymphocytes, particularly in pathogen-host interaction, in particular for virus such as Human adenovirus type 19 52 , HIV-1-induced cell apoptosis 53,54 and susceptibility to Hepatitis C 55,56 and herpes simplex virus 1 57 . Interestingly, HSV-1 this herpes virus has a high incidence in isolated Amerindians from the Peruvian and Brazilian Amazon [58][59][60] , with the elevated diversity of the virus and an endemic subtype that suggest an ancient endemic infection 61 .…”