Plasmablastic lymphoma of head and neck: report of two new cases and correlation with c-myc and IgVH gene mutation status.
Plasmablastic lymphoma (PBL) is a rare acquired immunodeficiency syndrome-associated non-Hodgkin's lymphoma (AIDS-NHL), with predilection for the mucosa of oral cavity. It usually has a plasmablastic morphology, expressing plasma cell-associated antigens with weak or absent expression of B-cell-associated markers. To further define the immunophenotypic and molecular genetics of these tumors, we investigated two cases of plasmablastic lymphomas of the head and neck for c-myc gene rearrangement and immunoglobulin heavy chain (IgV(H)) hypermutation status. For the first time we report a case of AIDS-related PBL that, by fluorescence in situ hybridization (FISH), shows a c-myc gene rearrangement. Although current literature suggests that most cases of c-myc gene rearranged AIDS-NHL are Burkitt's lymphoma, our case has an immunophenotype characteristic for PBL. In this case, IgV(H) hypermutation analysis showed a somatic hypermutation, indicative of germinal center transit. The concurrent B-cell immunophenotype of BCL-6(-)/CD138(+)/MUM-1(+) also suggests a post-germinal center B-cell origin of this lymphoma. The immunophenotype of our second case (BCL-6(-)/CD138(+)/MUM-1(+)) also suggests a post-germinal center B-cell origin. However, IgV(H) hypermutation analysis was not possible in this case.
Hassan
Anjum
A
Department of Pathology and Immunology, Division of Anatomic Pathology, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO 63110, USA. ahassan@path.wustl.edu
Kreisel
Friederike
F
Gardner
Laura
L
Lewis
James S
JS
El-Mofty
Samir K
SK
D000328:Adult; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics* / Q000276:immunology; D007135:Immunoglobulin Variable Region / Q000235:genetics* / Q000276:immunology; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D016483:Lymphoma, AIDS-Related / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D009154:Mutation; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics*; D027041:Somatic Hypermutation, Immunoglobulin / Q000235:genetics / Q000276:immunology
D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc