title: Plasmablastic lymphoma presenting as a large intracardiac mass and bilateral pleural effusions.
abstract: Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma arising most frequently in the oral cavity of HIV-infected patients. Rare cases of PBL have been reported in extra-oral sites, as well as in HIV-negative patients. Cardiac involvement by lymphoma is very rare. The most common primary cardiac lymphoma is diffuse large B-cell lymphoma. We report an unusual case of PBL in a 49-year-old, HIV-positive man presenting with a large intracardiac mass and bilateral pleural effusions. Histological examination of the cardiac mass biopsy and cytological evaluation of the pleural fluid demonstrated large lymphoma cells with plasmablastic differentiation. By immunohistochemistry, the large lymphoma cells expressed CD30, CD45, CD138, MUM1, and kappa light chain, were weakly positive for EMA, and were negative for T-cell and B-cell markers, lambda light chain, and human herpes virus 8 (HHV8). In situ hybridization for Epstein Barr Virus-encoded RNA (EBER) was negative in large lymphoma cells. To our knowledge, in the English literature, this is the second reported case of PBL with cardiac origin and the first reported case of PBL that presents as a combination of intracardiac mass and pleural effusions.
authors.affiliation: Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA. Electronic address: drqingx@yahoo.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Qing
authors.affiliation: Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Enbom
authors.affiliation: Terasaki Foundation Laboratory, 11570 West Olympic Boulevard, Los Angeles, CA 90064, USA.
authors.forename: Annie
authors.initials: A
authors.lastname: Qing
authors.affiliation: Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: French
authors.affiliation: Terasaki Foundation Laboratory, 11570 West Olympic Boulevard, Los Angeles, CA 90064, USA.
authors.forename: Junchao
authors.initials: J
authors.lastname: Cai
mesh_terms: D001402:B-Lymphocytes / Q000166:cytology / Q000821:virology; D003937:Diagnosis, Differential; D019288:Herpesvirus 8, Human; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000821:virology; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000175:diagnosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D000069293:Plasmablastic Lymphoma / Q000473:pathology* / Q000821:virology; D010996:Pleural Effusion / Q000175:diagnosis / Q000473:pathology
keywords: Epstein–Barr virus; HHV8; Plasmablastic lymphoma; Primary cardiac lymphoma