Plasmablastic lymphoma(PBL) is a rare aggressive B-cell lymphoproliferative disorder,which has been characterized by the World Health Organization as a new entity.Although PBL is most commonly seen in the oral cavity ...Plasmablastic lymphoma(PBL) is a rare aggressive B-cell lymphoproliferative disorder,which has been characterized by the World Health Organization as a new entity.Although PBL is most commonly seen in the oral cavity of human immunodeficiency virus(HIV)-positive patients,it can also be seen in extraoral sites in immunocompromised patients who are HIV-negative.Here we present a rare case of PBL of the small intestine in a 55-year-old HIV-negative male.Histopathological examination of the excisional lesion showed a large cell lymphoma with plasmacytic differentiation diffusely infiltrating the small intestine and involving the surrounding organs.The neoplastic cells were diffusely positive for CD79a,CD138 and CD10 and partly positive for CD38 and epithelial membrane antigen.Approximately 80% of the tumor cells were positive for Ki-67.A monoclonal rearrangement of the kappa light chain gene was demonstrated.The patient died approximately 1.5 mo after diagnosis in spite of receiving two courses of the CHOP chemotherapy regimen.In a review of the literature,this is the first case report of PBL with initial presentation in the small intestine without HIV and Epstein-Barr virus infection,and a history of hepatitis B virus infection and radiotherapy probably led to the iatrogenic immunocompromised state.展开更多
Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associat...Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associated with human immunodeficiency virus (HIV) and Epstein Barr virus infection, and shows an unusual tropism to the oral cavity. Herein we describe a patient with AIDS who presented with weight loss and dysphagia owing to a large gastroesophageal mass. His radiographic and endoscopic findings and long history of cigarette consumption suggested carcinoma. Biopsy demonstrated a poorly differentiated tumor stained negatively to routine lymphoid markers including CD20. However, gene rearrangement studies confirmed a B-cell process and a more detailed immunohistochemical analysis revealed the cells stained positively for CD138 (plasma cell antigen). These findings were diagnostic of PBL. Our report reviews the wide differential diagnosis of PBL and underscores the importance of a broad array of viral and molecular studies needed to establish this diagnosis.展开更多
Gastrointestinal involvement in plasma cell neoplasms,either as primary localizations(extramedullary plasma-cytomas) or as secondary involvement in systemic multiple myeloma, is a well-known event. Accurate histologic...Gastrointestinal involvement in plasma cell neoplasms,either as primary localizations(extramedullary plasma-cytomas) or as secondary involvement in systemic multiple myeloma, is a well-known event. Accurate histological examination is crucial in defining the diag-nosis. In this report, an uncommon case of duodenal localization of myeloma with plasmablastic features is described, with emphasis on the role of clinical data and findings from ancillary immunostaining techniques to avoid misdiagnosis.展开更多
IgG4-related disease(IgG4-RD) is a systemic fibroinflammatory disease with multiple organ disorders.Recently,in IgG4-RD,increased circulating plasmablasts have been found.The subsets of plasmablasts are negative for R...IgG4-related disease(IgG4-RD) is a systemic fibroinflammatory disease with multiple organ disorders.Recently,in IgG4-RD,increased circulating plasmablasts have been found.The subsets of plasmablasts are negative for RP105(CD180).A large population of B cells lacking RP105(RP105-negative B cells) are found inpatients with active with systemic lupus erythematosus and other systemic autoimmune diseases,including dermatomyositis,and Sj?gren's syndrome.In other conditions,such as neuromyelitis optica,Kawasaki's disease,primary biliary cirrhosis and aging,RP105 expression on B cells and monocytes also alters.We review the basic science and clinical significance of RP105-negative B cells including plasmablasts in various immune-based diseases.RP105-negative B cells,especially plasmablasts,play crucial roles in both systemic and organ-specific autoimmune and inflammatory disorders.展开更多
Plasmablastic lymphoma(PBL)is a very rare B-cell lymphoproliferative disorder was with an aggressive clinical behavior that recently characterized by the World Health Organization.Although PBL is most commonly observe...Plasmablastic lymphoma(PBL)is a very rare B-cell lymphoproliferative disorder was with an aggressive clinical behavior that recently characterized by the World Health Organization.Although PBL is most commonly observed in the oral cavity of human immunodeficiency virus(HIV)-positive patients,it can also be observed at extra-oral sites in HIV-negative patients.Epstein-Barr virus(EBV)may be closely related the pathogenesis of PBL.PBL shows different clinicopathological characteristics between HIV-positive and-negative patients.Here,we report a case of PBL of the liver in a 79-yearold HIV-negative male.The patient died approximately1.5 mo after examination and autopsy showed that the main lesion was a very large liver mass.Histopathological examination of the excised lesion showed large-cell lymphoma with plasmacytic differentiation diffusely infiltrating the liver and involving the surrounding organs.The neoplastic cells were diffusely positive for CD30,EBV,Bob-1,and CD38.The autopsy findings suggested a diagnosis of PBL.To our knowledge,the present case appears to be the first report of PBL with initial presentation of the liver in a patient without HIV infection.展开更多
Plasmablastic lymphoma(PBL) is a rare form of nonHodgkin's lymphoma that is associated with human immunodeficiency virus(HIV) infection. Although PBL is most commonly observed in the oral cavity of HIV-positive pa...Plasmablastic lymphoma(PBL) is a rare form of nonHodgkin's lymphoma that is associated with human immunodeficiency virus(HIV) infection. Although PBL is most commonly observed in the oral cavity of HIV-positive patients, it can also be observed at extra-oral sites in HIV-negative patients. This report represents an unusual case of HIV-negative PBL that occurred in the sigmoid colon. This patient had a history of systemic lupus erythematosus and an underlying immunosuppressive state from long term steroid therapy. The lymphoma cells were positive for CD138, kappa light chain restriction and Epstein-Barr virus and negative for CD20/L26, CD3, CD79 a, UCHL1(CD45RO) and cytokeratin(AE1/AE3). The patient died approximately 2 mo after the operation. In the present paper, we review cases of PBL of the colon in HIVnegative patients.展开更多
Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar c...Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar case reports published in peer-reviewed journals. In our first case, a 40 year-old human immunodeficiency virus positive male presented with a hemorrhoid-like sensation, and was diagnosed with PBL via biopsy of a rectal mass. The second case involves a 65 year-old healthy male with bloody diarrhea who was found to have PBL in a resected sigmoid mass. The third patient was a 41 year-old male with a history of Crohn’s disease who presented with abdominal pain, diarrhea, and weight loss. A small intestinal mass (PBL) was removed. The fourth patient was a 65-year-old male who was found PBL after surgical resection of bowel for his florid Crohn’s disease. He later developed secondary acute myeloid leukemia. Clinical outcome was very poor in 3 out of 4 patients as reported in the literature. One patient survived chemotherapy followed by autologous transplant. The prototypical clinical presentation and variations of PBL can help create a more comprehensive differential diagnosis for GI tumors and establish an appropriate therapeutic guideline.展开更多
Plasmablastic lymphoma(PBL)is an aggressive lymphoma with limited treatment strategies.Tuberculosis(TB)infection poses a high risk for patients with hematologic malignancies,especially those treated with immune agents...Plasmablastic lymphoma(PBL)is an aggressive lymphoma with limited treatment strategies.Tuberculosis(TB)infection poses a high risk for patients with hematologic malignancies,especially those treated with immune agents but were never reported postdaratumumab treatment.Herein,we reported a TB infection in a 57-year-old male diagnosed with HIV-negative PBL receiving daratumumab-based treatment,who showed atypical lung infection and yielded Mycobacterium tuberculosis and cytomegalovirus(CMV)in the bronchoalveolar lavage fluid.Anti-TB therapy was administered,and the following daratumumab treatment was complete with good tolerance.In this case,we demonstrated that TB infection might occur after daratumumab therapy,and adequate attention should be paid to atypical symptoms.展开更多
As Hong and Sung[1] previously did, we read with great interest the study published by Guptill et al.[2] They reported that anti-muscle-specific kinase (MuSK) myasthenia gravis patients and healthy controls had simila...As Hong and Sung[1] previously did, we read with great interest the study published by Guptill et al.[2] They reported that anti-muscle-specific kinase (MuSK) myasthenia gravis patients and healthy controls had similar percentages of peripheral plasmablasts.展开更多
Extramedullary disease(EMD)of multiple myeloma(MM)can present as paraskeletal(paraosseous)plasmocytoma(PP)that arise from skeletal focal lesions or extramedullary plasmacytomas(EMP)that derive from hematogenous spread...Extramedullary disease(EMD)of multiple myeloma(MM)can present as paraskeletal(paraosseous)plasmocytoma(PP)that arise from skeletal focal lesions or extramedullary plasmacytomas(EMP)that derive from hematogenous spread.The pathogenetic mechanisms that distinguish classical MM,PP,and EMP are still insufficiently known,as are the therapies that would be effective in EMD.The aim of this study was to evaluate immunohistochemically the angiogenesis,determined as microvessel density(MVD)and osteopontin expression in PP,of two patients with MM of plasmablastic morphology and an aggressive course of disease.We found high levels of MVD and osteopontin expression in both cases of PP.The role of angiogenesis and osteopontin in EMD should be clarified in future investigations,especially since there are no satisfactory therapeutic protocols for this form of multiple myeloma,and both of these biological factors can be the potential targets of new therapies.展开更多
Post-transplant lymphoproliferative disorder(PTLD) is an aggressive complication of solid organ and hematopoietic stem cell transplantation that arises in up to 20% of transplant recipients. Infection or reactivation ...Post-transplant lymphoproliferative disorder(PTLD) is an aggressive complication of solid organ and hematopoietic stem cell transplantation that arises in up to 20% of transplant recipients. Infection or reactivation of the Epstein-Barr virus(EBV), a ubiquitous human herpesvirus, in combination with chronic immunosuppression are considered as the main predisposing factors, however insight in PTLD biology is fragmentary. The study of PTLD is complicated by its morphological heterogeneity and the lack of prospective trials, which also impede treatment optimization. Furthermore, the broad spectrum of underlying disorders and the graft type represent important confounding factors. PTLD encompasses different malignant subtypes that resemble histologically similar lymphomas in the general population. Post-transplant diffuse large B-cell lymphoma(PT-DLBCL), Burkitt lymphoma(PTBL) and plasmablastic lymphoma(PT-PBL) occur most frequently. However, in many studies various EBV+ and EBV- PTLD subtypes are pooled, complicating the interpretation of the results. In this review, studies of the gene expression pattern, the microenvironment and the genetic profile of PT-DLBCL, PT-BL and PT-PBL are summarized to better understand the mechanisms underlying post-transplantation lymphomagenesis. Based on the available findings we propose stratification of PTLD according to the histological subtype and the EBV status to facilitate the interpretation of future studies and the establishment of clinical trials.展开更多
文摘Plasmablastic lymphoma(PBL) is a rare aggressive B-cell lymphoproliferative disorder,which has been characterized by the World Health Organization as a new entity.Although PBL is most commonly seen in the oral cavity of human immunodeficiency virus(HIV)-positive patients,it can also be seen in extraoral sites in immunocompromised patients who are HIV-negative.Here we present a rare case of PBL of the small intestine in a 55-year-old HIV-negative male.Histopathological examination of the excisional lesion showed a large cell lymphoma with plasmacytic differentiation diffusely infiltrating the small intestine and involving the surrounding organs.The neoplastic cells were diffusely positive for CD79a,CD138 and CD10 and partly positive for CD38 and epithelial membrane antigen.Approximately 80% of the tumor cells were positive for Ki-67.A monoclonal rearrangement of the kappa light chain gene was demonstrated.The patient died approximately 1.5 mo after diagnosis in spite of receiving two courses of the CHOP chemotherapy regimen.In a review of the literature,this is the first case report of PBL with initial presentation in the small intestine without HIV and Epstein-Barr virus infection,and a history of hepatitis B virus infection and radiotherapy probably led to the iatrogenic immunocompromised state.
文摘Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associated with human immunodeficiency virus (HIV) and Epstein Barr virus infection, and shows an unusual tropism to the oral cavity. Herein we describe a patient with AIDS who presented with weight loss and dysphagia owing to a large gastroesophageal mass. His radiographic and endoscopic findings and long history of cigarette consumption suggested carcinoma. Biopsy demonstrated a poorly differentiated tumor stained negatively to routine lymphoid markers including CD20. However, gene rearrangement studies confirmed a B-cell process and a more detailed immunohistochemical analysis revealed the cells stained positively for CD138 (plasma cell antigen). These findings were diagnostic of PBL. Our report reviews the wide differential diagnosis of PBL and underscores the importance of a broad array of viral and molecular studies needed to establish this diagnosis.
文摘Gastrointestinal involvement in plasma cell neoplasms,either as primary localizations(extramedullary plasma-cytomas) or as secondary involvement in systemic multiple myeloma, is a well-known event. Accurate histological examination is crucial in defining the diag-nosis. In this report, an uncommon case of duodenal localization of myeloma with plasmablastic features is described, with emphasis on the role of clinical data and findings from ancillary immunostaining techniques to avoid misdiagnosis.
文摘IgG4-related disease(IgG4-RD) is a systemic fibroinflammatory disease with multiple organ disorders.Recently,in IgG4-RD,increased circulating plasmablasts have been found.The subsets of plasmablasts are negative for RP105(CD180).A large population of B cells lacking RP105(RP105-negative B cells) are found inpatients with active with systemic lupus erythematosus and other systemic autoimmune diseases,including dermatomyositis,and Sj?gren's syndrome.In other conditions,such as neuromyelitis optica,Kawasaki's disease,primary biliary cirrhosis and aging,RP105 expression on B cells and monocytes also alters.We review the basic science and clinical significance of RP105-negative B cells including plasmablasts in various immune-based diseases.RP105-negative B cells,especially plasmablasts,play crucial roles in both systemic and organ-specific autoimmune and inflammatory disorders.
文摘Plasmablastic lymphoma(PBL)is a very rare B-cell lymphoproliferative disorder was with an aggressive clinical behavior that recently characterized by the World Health Organization.Although PBL is most commonly observed in the oral cavity of human immunodeficiency virus(HIV)-positive patients,it can also be observed at extra-oral sites in HIV-negative patients.Epstein-Barr virus(EBV)may be closely related the pathogenesis of PBL.PBL shows different clinicopathological characteristics between HIV-positive and-negative patients.Here,we report a case of PBL of the liver in a 79-yearold HIV-negative male.The patient died approximately1.5 mo after examination and autopsy showed that the main lesion was a very large liver mass.Histopathological examination of the excised lesion showed large-cell lymphoma with plasmacytic differentiation diffusely infiltrating the liver and involving the surrounding organs.The neoplastic cells were diffusely positive for CD30,EBV,Bob-1,and CD38.The autopsy findings suggested a diagnosis of PBL.To our knowledge,the present case appears to be the first report of PBL with initial presentation of the liver in a patient without HIV infection.
文摘Plasmablastic lymphoma(PBL) is a rare form of nonHodgkin's lymphoma that is associated with human immunodeficiency virus(HIV) infection. Although PBL is most commonly observed in the oral cavity of HIV-positive patients, it can also be observed at extra-oral sites in HIV-negative patients. This report represents an unusual case of HIV-negative PBL that occurred in the sigmoid colon. This patient had a history of systemic lupus erythematosus and an underlying immunosuppressive state from long term steroid therapy. The lymphoma cells were positive for CD138, kappa light chain restriction and Epstein-Barr virus and negative for CD20/L26, CD3, CD79 a, UCHL1(CD45RO) and cytokeratin(AE1/AE3). The patient died approximately 2 mo after the operation. In the present paper, we review cases of PBL of the colon in HIVnegative patients.
文摘Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar case reports published in peer-reviewed journals. In our first case, a 40 year-old human immunodeficiency virus positive male presented with a hemorrhoid-like sensation, and was diagnosed with PBL via biopsy of a rectal mass. The second case involves a 65 year-old healthy male with bloody diarrhea who was found to have PBL in a resected sigmoid mass. The third patient was a 41 year-old male with a history of Crohn’s disease who presented with abdominal pain, diarrhea, and weight loss. A small intestinal mass (PBL) was removed. The fourth patient was a 65-year-old male who was found PBL after surgical resection of bowel for his florid Crohn’s disease. He later developed secondary acute myeloid leukemia. Clinical outcome was very poor in 3 out of 4 patients as reported in the literature. One patient survived chemotherapy followed by autologous transplant. The prototypical clinical presentation and variations of PBL can help create a more comprehensive differential diagnosis for GI tumors and establish an appropriate therapeutic guideline.
基金the fundings from the National Natural Science Foundation of China(81873427 and 82070217 to Dr.Jia Wei)CHEN XIAO-PING Foundation for the Development of Science and Technology of Hubei Province(CXPJJH12000009-113,to Dr.Jia Wei).
文摘Plasmablastic lymphoma(PBL)is an aggressive lymphoma with limited treatment strategies.Tuberculosis(TB)infection poses a high risk for patients with hematologic malignancies,especially those treated with immune agents but were never reported postdaratumumab treatment.Herein,we reported a TB infection in a 57-year-old male diagnosed with HIV-negative PBL receiving daratumumab-based treatment,who showed atypical lung infection and yielded Mycobacterium tuberculosis and cytomegalovirus(CMV)in the bronchoalveolar lavage fluid.Anti-TB therapy was administered,and the following daratumumab treatment was complete with good tolerance.In this case,we demonstrated that TB infection might occur after daratumumab therapy,and adequate attention should be paid to atypical symptoms.
文摘As Hong and Sung[1] previously did, we read with great interest the study published by Guptill et al.[2] They reported that anti-muscle-specific kinase (MuSK) myasthenia gravis patients and healthy controls had similar percentages of peripheral plasmablasts.
基金This work was supported by the Research Support of the University of Rijeka:grant No.918.10.0104。
文摘Extramedullary disease(EMD)of multiple myeloma(MM)can present as paraskeletal(paraosseous)plasmocytoma(PP)that arise from skeletal focal lesions or extramedullary plasmacytomas(EMP)that derive from hematogenous spread.The pathogenetic mechanisms that distinguish classical MM,PP,and EMP are still insufficiently known,as are the therapies that would be effective in EMD.The aim of this study was to evaluate immunohistochemically the angiogenesis,determined as microvessel density(MVD)and osteopontin expression in PP,of two patients with MM of plasmablastic morphology and an aggressive course of disease.We found high levels of MVD and osteopontin expression in both cases of PP.The role of angiogenesis and osteopontin in EMD should be clarified in future investigations,especially since there are no satisfactory therapeutic protocols for this form of multiple myeloma,and both of these biological factors can be the potential targets of new therapies.
文摘Post-transplant lymphoproliferative disorder(PTLD) is an aggressive complication of solid organ and hematopoietic stem cell transplantation that arises in up to 20% of transplant recipients. Infection or reactivation of the Epstein-Barr virus(EBV), a ubiquitous human herpesvirus, in combination with chronic immunosuppression are considered as the main predisposing factors, however insight in PTLD biology is fragmentary. The study of PTLD is complicated by its morphological heterogeneity and the lack of prospective trials, which also impede treatment optimization. Furthermore, the broad spectrum of underlying disorders and the graft type represent important confounding factors. PTLD encompasses different malignant subtypes that resemble histologically similar lymphomas in the general population. Post-transplant diffuse large B-cell lymphoma(PT-DLBCL), Burkitt lymphoma(PTBL) and plasmablastic lymphoma(PT-PBL) occur most frequently. However, in many studies various EBV+ and EBV- PTLD subtypes are pooled, complicating the interpretation of the results. In this review, studies of the gene expression pattern, the microenvironment and the genetic profile of PT-DLBCL, PT-BL and PT-PBL are summarized to better understand the mechanisms underlying post-transplantation lymphomagenesis. Based on the available findings we propose stratification of PTLD according to the histological subtype and the EBV status to facilitate the interpretation of future studies and the establishment of clinical trials.
