Oral cavity and extra-oral plasmablastic lymphomas in AIDS patients: report of five cases and review of the literature

Abstract

Plasmablastic lymphoma (PBL) is a distinct disease entity of the diffuse large B-cell lymphoma, which often occurs in HIV-positive patients. The immunophenotype of this lymphoid neoplasm is characterized by the presence of plasma cell-associated markers VS38c and CD138 antigens and the absence of B-cell markers such as CD20 and CD45. The most frequent site of involvement is the oral cavity and the jaw, while several reports describe the development of PBL in extra-oral sites including the lymph nodes, the anal canal, the soft tissue, the skin and the gastrointestinal tract as less frequent. Epstein-Barr virus is often associated with PBL pathogenesis and the neoplastic cells contain this virus genome. Here we review the epidemiological, clinical, immunological, histopathological and virological characteristics and their prognosis and outcome in a series of five patients with diagnoses of HIV/AIDS and PBL.

Pathology of lymphoma in HIV

“…The stringency of the criteria used for classification of PBL has varied over time, leading some studies to use a very strict definition (including presentation in the oral cavity and presence of EBV) which has resulted in this tumor being considered extremely rare (38), to a more general definition provided by the WHO that accepts EBV-negative cases and extra-oral presentation, as long as the morphology and immunophenotype is that of B immunoblasts or plasma cells (41). A recent report of five cases with a review of the literature identified 248 PBL cases, out of which 157 were in HIV-positive patients, 43% were outside the oral cavity and EBV was identified in 86% (42). This is a highly aggressive tumor with a median survival of around 14 months.…”

Spontaneous Regression of an Oral Manifestation of Plasmablastic Lymphoma: Literature Review and Commentary about the Phenomena

“…This finding was reported initially in HIV+ patients that start the use of highly active antiretroviral therapy (HAART) [4,5,6] or yet which interrupted this therapy [7]. This phenomena has been seen in PBL in HIV+ patients with undetectable viral range and with immune system stable after the performance of an incisional biopsy [8,9].…”

Diagnosis and Management of Cutaneous B-cell Lymphoma

“…18 T cell-rich B-cell lymphoma, a type of large B-cell lymphoma rich in T-cells in association with a limited number of scattered large malignant B cells 19 and plasmablastic lymphomas, have also been described as presenting primarily in skin; plasmablastic lymphomas often being seen in individuals infected with human immunodeficiency virus. 20 Mucocutaneous ulcer represents an EBV-driven cutaneous lymphoproliferative disorder that is associated with immunodeficiency. It presents with sharply demarcated ulcers in skin or mucosa, largely in individuals with either immune senescence of age or iatrogenic immune suppression.…”