Plasmablastic lymphoma in HIV+ patients: an expanding spectrum.
AIM: To describe an unusual human immunodeficiency virus (HIV)-associated lymphoma in uncommon sites. Plasmablastic lymphoma is a distinctive HIV-associated tumour that was first described in the jaws and oral cavity. Only two cases (stomach and lung) have been documented in extra-oral sites. MATERIALS AND METHODS: Four cases were encountered in HIV+ patients: three in the anorectal region and one which was nasal and paranasal. The cases were routinely processed and immunohistochemistry was performed on formalin-fixed paraffin-embedded tissue. RESULTS: The cases showed the typical morphological appearances of a high-grade, blastic non-Hodgkin's lymphoma (brisk mitotic activity and tingible body macrophages). In addition, some cells had a plasmacytoid appearance and paranuclear clearing. Immunophenotypically, the tumour cells were negative for LCA, CD20 and CD45RA. However, a small proportion of cells (5%) were immunoreactive for CD79a and the majority were positive with VS38c, indicative of plasma cell differentiation. Kappa light chain and IgG heavy chain restriction was also detected. CONCLUSIONS: Plasmablastic lymphoma may occur in extra-oral sites and has a characteristic immunophenotype including focal expression of CD31 by the neoplastic cells. Awareness of the absence of expression of conventional B-cell markers and its presence in unusual sites should facilitate the diagnosis of plasmablastic lymphoma in HIV+ patients.[1]References
- Plasmablastic lymphoma in HIV+ patients: an expanding spectrum. Chetty, R., Hlatswayo, N., Muc, R., Sabaratnam, R., Gatter, K. Histopathology (2003) [Pubmed]
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