title: HIV-negative plasmablastic lymphoma: not in the mouth.
abstract: Plasmablastic lymphoma (PBL) is an aggressive variant of non-Hodgkin lymphoma initially reported in the oral cavity of HIV-positive individuals. Since its original description, several cases have been reported in patients who do not have HIV infection. However, despite its recognition as a distinct subtype of diffuse large B-cell lymphoma several years ago, comprehensive reviews of this entity are lacking. A MEDLINE search through June 2010 was performed to identify cases with a pathologic diagnosis of HIV-negative PBL based on morphology and minimal immunohistochemical criteria. Our study included a total of 76 cases. The median age was 57 years (range, 1 to 90 years) with a male-to-female ratio of 1.7. Seventy-four percent of cases did not have an apparent association with immunosuppression, 18% had a concurrent lymphoproliferative or autoimmune disorder and 9% developed PBL after solid organ transplantation. Oral involvement was observed in 21%, advanced stage in 60%, Epstein-Barr virus-encoded RNA expression was positive in 45% and Ki-67 expression of greater than or equal to 80% in 61% of the cases. Chemotherapy was documented in 43 patients, from which 43% received the cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)-like regimens. The median and the 2-year overall survival for the whole group were 9 months and 10%, respectively. Patients who had HIV-negative PBL have distinct clinicopathological characteristics, such as short overall survival and lower rates of oral involvement and Epstein-Barr virus-encoded RNA expression than the previously reported in HIV-positive patients.
authors.affiliation: The Warren Alpert Medical School of Brown University, Providence, RI, USA.jcastillo@lifespan.org
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Castillo
authors.forename: Eric S
authors.initials: ES
authors.lastname: Winer
authors.forename: Dariusz
authors.initials: D
authors.lastname: Stachurski
authors.forename: Kimberly
authors.initials: K
authors.lastname: Perez
authors.forename: Melhem
authors.initials: M
authors.lastname: Jabbour
authors.forename: Cannon
authors.initials: C
authors.lastname: Milani
authors.forename: Gerald A
authors.initials: GA
authors.lastname: Colvin
authors.forename: James N
authors.initials: JN
authors.lastname: Butera
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D018023:HIV Seronegativity / Q000276:immunology*; D006801:Humans; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D009055:Mouth / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014408:Biomarkers, Tumor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone