title: Extramedullary plasmacytoma: an unusual neoplasm in a HIV-positive patient.
abstract: There is a wide range of plasma cell abnormalities in people living with HIV (PLHIV). Extramedullary plasmacytomas are not common in HIV infection, unlike plasmablastic lymphomas. An HIV-positive 44-year-old man on antiretroviral therapy presented with a rapidly progressing swelling on the face. Imaging revealed underlying bone destruction. Histologically, there was a tumour composed of small to medium-sized plasmacytoid cells admixed with many mature plasma cells and plasmablasts. These were positive for CD138 and MUM 1. Extramedullary multiple myeloma was ruled out as CD56 and cyclin D-1 were negative. EBV was negative. As the tumour cells were mostly mature, plasmablastic lymphoma was also excluded. The presence of a monoclonal protein (1 g%), IgG kappa type, was detected. Neoplasia of plasma cells acquires special clinical characteristics in PLHIV. These patients are younger, with a greater tendency to develop solitary extramedullary plasmacytomas with atypical clinical evolution and greater aggressiveness of the neoplastic process. All of these features, along with a high proliferation index (MIB1 60%) was found in our patient. We report this case for its rarity, histopathological dilemma and its atypical features in HIV infection.
authors.affiliation: Department of Dermatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India anjusushil2005@gmail.com.
authors.forename: Anjana A
authors.initials: AA
authors.lastname: Joseph
authors.affiliation: Department of Dermatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
authors.forename: Susanne
authors.initials: S
authors.lastname: Pulimood
authors.affiliation: Department of Pathology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
authors.forename: Marie T
authors.initials: MT
authors.lastname: Manipadam
authors.affiliation: Department of Haematology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
authors.forename: Auro
authors.initials: A
authors.lastname: Viswabandya
authors.affiliation: Department of Pathology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
authors.forename: Elanthenral
authors.initials: E
authors.lastname: Sigamani
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D010954:Plasmacytoma / Q000473:pathology*
chemical_list: D044966:Anti-Retroviral Agents
keywords: AIDS; HIV; cancer; extramedullary; plasmacytoma