Plasmablastic Lymphoma of the Anal Canal in an HIV-Infected Patient

Abstract

Patient: Female, 46Final Diagnosis: Plasmablastic lymphomaSymptoms: Fecal incontinenceMedication: ChemotherapyClinical Procedure: Anal canal biopsySpecialty: Internal medicine • Oncology • RadiologyObjective:Unusual clinical courseBackground:The advent of antiretroviral therapy increased the life expectancy of human immunodeficiency virus (HIV)-positive patients and, consequently, the morbidity and mortality due to neoplasms. Plasmablastic lymphoma is one such neoplasm that generally presents with involvement of the oral cavity; cases of extra-oral involvement are rare.Case Report:We report a case of plasmablastic lymphoma in a 46-year-old woman for whom the initial clinical manifestation was a painless perineal tumor accompanied by fecal incontinence.Conclusions:The possibility of this neoplasm should be considered in patients with HIV/acquired immune deficiency syndrome (HIV/AIDS) because its early diagnosis is essential so that the start of the treatment is not delayed.

Plasmablastic lymphoma in an HIV-negative patient with complete remission after chemotherapy with DA-EPOCH

“…In images such as computed tomography or nuclear magnetic resonance, most cases of lymphoma of the gastrointestinal tract usually present as a concentric mural mass that infiltrates adjacent tissues. It may or may not cause luminal stenosis, as well as the formation of fistulas [2,6]. In the present case, there is evidence of wall thickening with the involvement of the ischiorectal fossa, levator ani muscle, obturator internus, seminal vesicles, and the formation of a complex anorectal fistula.…”

“…Due to the highly variable presentation of the various lesions in the anorectal region, other possible differential diagnoses should be taken into account in similar cases in addition to adenocarcinoma of the rectum. This would include inflammatory bowel disease, pelvic actinomycosis, tuberculosis, nocardiosis, neoplasms of epithelial origin, melanoma, and lymphoma [2].…”

“…This was first described in 1997 in the oral cavity of patients with human immunodeficiency virus (HIV) infection. This began being considered an acquired immunodeficiency syndrome (AIDS)-defining neoplasm [1][2][3][4][5]. This represents approximately 2% of HIV-related lymphomas and less than 3% of all non-Hodgkin lymphomas [1,4].…”

“…This has been reported in several locations other than the one initially described in the oral cavity. The gastrointestinal tract, lymph nodes, and skin stand out, with the gastrointestinal tract being a rather challenging location in terms of its diagnosis [1][2][3][4][5]. Due to its difficult diagnosis because of its clinical presentation and variable location, it can initially be confused with other neoplasms of the gastrointestinal tract [1].…”

A Rare Case of HIV-Associated Plasmablastic Lymphoma of Anal Canal

“…However, MRI is the investigation of choice for anal canal lymphomas due to its superior diagnostic ability for invasion of surrounding structures. The lesion usually shows poor contrast uptake and diffusion restriction, showing homogeneous intermediate T1 signal and an intermediate/high T2 signal [ 8 , 9 ]. Moreover, MRI can also detect bone marrow involvement, seen in one-third of patients with PBL [ 10 ].…”