Oral and Extraoral Plasmablastic Lymphoma

Abstract

Plasmablastic lymphoma (PBL), initially characterized as an aggressive lymphoma arising in the jaw and oral mucosa in HIV-infected patients, was recently reported to occur with extraoral manifestations, heterogeneous histologic findings, and variable association with immunodeficiency states. We reviewed clinical, morphologic, and immunophenotypic features of 13 cases of PBL to determine whether these different subtypes represent distinct morphologic and clinical entities. Two distinct subtypes of PBL were identified and classified as oral and extraoral PBL. The oral PBLs were strongly associated with HIV infection and commonly demonstrated plasmablastic morphologic features without plasmacytic differentiation. Extraoral PBLs tended to occur in patients with underlying non-HIV-related immunosuppression and universally demonstrated plasmacytic differentiation. The patients with oral PBL demonstrated better overall survival compared with patients with extraoral PBL (P = .02). Our findings suggest that PBL with oral and extraoral manifestation represent 2 distinct clinicopathologic entities.

Bone marrow necrosis as clinical presentation of plasmablastic lymphoma in an AIDS patient: First case reported and literature review

“…There are a few reports in the medical literature of cases of extra-oral compromise as we could see in our patient. The immunophenotype of this lymphoid neoplasm is consistent with the plasma cell-markers associated antigens VSC38c and CD 138 AS CD28 ABD CD 45 [15] .…”

Plasmablastic lymphoma of the anus: a case report

“…The prognosis is usually very poor and reported survival is less than a year. Hansara et al reported a better overall survival in patients with PBL of extra-oral sites when compared to patients with oral PBL [10] . Some authors have described a better prognosis in HIV positive patients with PBL as compared to HIV negative patients with PBL [14] .…”

“…Some authors have reported that plasmacytic differentiation is more likely to be seen in extra-oral type of PBL [9,10] . On the other hand, others have reported plasmacytic differentiation in large percentage (57%) of oral PBL [11] .…”

“…In such cases, use of other markers of plasma cell differentiation such as BLIMP-1/PRDM1 and XBP1 may be helpful [12] . Some authors have reported that extra-oral type of PBL is more likely to show CD56 expression as compared to the oral type [10] . Further studies are needed to find out whether extra-oral type of PBL represents a distinct subset.…”

Extraoral Plasmablastic Lymphoma Detected Using Ascitic Fluid Cytology and Flow Cytometry: A Case Report with a Review of the Literature

“…The landmark paper written by Delecluse et al [5], which gave the first description of PL, found HIV positivity in 15 of the 16 cases studied. However, it is also known that the there is a weaker association of EoPL with HIV [11]. Amongst the PL studies that examined for EBV, nearly 64% found EBV positivity.…”