title: Plasmablastic lymphoma of head and neck: report of two new cases and correlation with c-myc and IgVH gene mutation status.
abstract: 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.
authors.affiliation: 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
authors.forename: Anjum
authors.initials: A
authors.lastname: Hassan
authors.forename: Friederike
authors.initials: F
authors.lastname: Kreisel
authors.forename: Laura
authors.initials: L
authors.lastname: Gardner
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Samir K
authors.initials: SK
authors.lastname: El-Mofty
mesh_terms: 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
chemical_list: D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc