title: Plasmablastic lymphoma: Cytologic findings in 5 cases with unusual presentation.
abstract: BACKGROUND
  Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin lymphoma that was once believed to occur primarily in the oral cavity of human immunodeficiency virus-positive individuals. Numerous extraoral sites have also been reported to date. To the authors' knowledge, however, only 3 reports in the literature describe its cytologic features. In the current study, the cytologic findings in 5 additional patients are reported, 3 of whom had concomitant second malignancies. The goal of the current study was to define the cytomorphologic features that may help to distinguish PBL from other mimics.
  
  
  METHODS
  Five cases were identified from the pathology files for which cytology was available. The presence of the following was evaluated: cellularity, plasmablastic cells, background necrosis (BN), single-cell necrosis (SCN), lymphoglandular bodies (LGB), tingible-body macrophages (TBM), 3-dimensional clusters/sheets, and cytoplasmic vacuoles.
  
  
  RESULTS
  The patients included 3 women and 2 men with an age range of 40 to 57 years. Two patients had the acquired immunodeficiency syndrome and 3 had second non-PBL related malignancies including endometrial carcinoma, lung adenocarcinoma, and small lymphocytic lymphoma. The most common cytologic features were hypercellularity (80%), plasmablastic cells (73%), SCN (73%), BN (87%), and LGB (66%). TBMs (33%) and clusters/sheets (47%) were the least common features.
  
  
  CONCLUSIONS
  Although no 1 cytologic feature is diagnostic of PBL, a constellation of findings should raise suspicion. These include hypercellular specimens with abundant plasmablastic cells, LGB, SCN, and BN. However, although these findings may suggest PBL, a definitive diagnosis requires adjunctive studies including immunohistochemistry and flow cytometry. As with any lymphocyte-rich aspirate, additional material should be collected for these studies. Over-reliance on adjuvant studies is discouraged because the PBL immunophenotype is not considered standard.
authors.affiliation: Department of Pathology, Medical College of Georgia, Augusta, Georgia 30912, USA. mrnicholson@mcg.edu
authors.forename: Michelle
authors.initials: M
authors.lastname: Reid-Nicholson
authors.forename: Sravankumar
authors.initials: S
authors.lastname: Kavuri
authors.forename: Celalettin
authors.initials: C
authors.lastname: Ustun
authors.forename: Jennifer
authors.initials: J
authors.lastname: Crawford
authors.forename: Asha
authors.initials: A
authors.lastname: Nayak-Kapoor
authors.forename: Preetha
authors.initials: P
authors.lastname: Ramalingam
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology