AIDS-associated plasmablastic lymphoma presenting as a poorly differentiated esophageal tumor: a diagnostic dilemma.
Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associated with human immunodeficiency virus (HIV) and Epstein Barr virus infection, and shows an unusual tropism to the oral cavity. Herein we describe a patient with AIDS who presented with weight loss and dysphagia owing to a large gastroesophageal mass. His radiographic and endoscopic findings and long history of cigarette consumption suggested carcinoma. Biopsy demonstrated a poorly differentiated tumor stained negatively to routine lymphoid markers including CD20. However, gene rearrangement studies confirmed a B-cell process and a more detailed immunohistochemical analysis revealed the cells stained positively for CD138 (plasma cell antigen). These findings were diagnostic of PBL. Our report reviews the wide differential diagnosis of PBL and underscores the importance of a broad array of viral and molecular studies needed to establish this diagnosis.
Mani
Deepthi
D
Division of Hematology and Oncology, Virginia Mason Medical Center, Seattle, Washington WA 98111, United States.
Guinee
Donald-G
DG
Aboulafia
David-M
DM
D051997:ADP-ribosyl Cyclase 1 / Q000096:biosynthesis; D000328:Adult; D018951:Antigens, CD20 / Q000096:biosynthesis; D002454:Cell Differentiation; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods; D004938:Esophageal Neoplasms / Q000150:complications* / Q000175:diagnosis*; D015321:Gene Rearrangement; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D010950:Plasma Cells / Q000473:pathology*; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis
D018951:Antigens, CD20; D051997:ADP-ribosyl Cyclase 1