Journal List > Korean J Hematol > v.43(3) > 1032787

TOOLS
Lee, Kim, Bae, Kim, Lee, Lee, Park, Hong, Park, Jin, and Won: Plasmablastic Lymphoma Mistaken for Perianal Abscess in Patient with AIDS
Case Report

Korean J Hematol 2008;43(3):198-202.

Published online: 19 September 2008

DOI: https://doi.org/10.5045/kjh.2008.43.3.198

Plasmablastic Lymphoma Mistaken for Perianal Abscess in Patient with AIDS

Sang-Cheol Lee1, Hyun-Jung Kim1, Sang-Byung Bae1, Chan-Kyu Kim1, Nam-Su Lee1, Kyu-Taek Lee1, Sung-Kyu Park1, Dae-Sik Hong1, Hee-Sook Park1, So-Young Jin2, Jong-Ho Won1,

1Division of Hematology & Oncology, Department of Internal Medicine, Seoul, Korea

2Department of Pathology, College of Medicine, Soonchunhyang University, Seoul, Korea

Correspondence to：Jong-Ho Won, M.D. Department of Internal Medicine, College of Medicine, Soon-chunhyang University 22, Daesagwan-gil, Yongsan-gu, Seoul 140-743, Korea Tel: ＋82-2-709-9203, Fax: ＋82-2-797-1176 E-mail: jhwon@hosp.sch.ac.kr

Received 1 April 2008       Revised 18 July 2008       Accepted 24 July 2008

Copyright © 2008 Korean Society of Hematology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with acquired immunodeficiency virus (AIDS) are at increased risk for B-cell neoplasms and plasma cell dyscrasias. Plasmablastic lympomas (PBLs) were originally described exclusively in HIV-positive patients who presented with jaw or oral mucosa involvement. Recent studies report that this neoplasm also occurs in patients without HIV infection and may involve sites other than the head and neck. Until now, only sinus, oral mucosa, bone, testicles, gastrointestinal and pulmonary manifestations have been reported. In this report we describe a 41-year-old male with AIDS who mistook plasmablastic lymphoma of the pelvic cavity for perianal abscess. The patient presented with multiple involvement of bone and highly aggressive progression of pelvic mass without the involvement of bone marrow.

Keywords: Plasmablastic lymphoma, Acquired immunodeficiency syndrome, Abscess, Perianal

REFERENCES

1). Franceschi S., Dal Maso L., La Vecchia C. Advances in the epidemiology of HIV-associated non-Hodgkin's lymphoma and other lymphoid neoplasms. Int J Cancer. 1999. 83:481–5.
crossref
2). Navarro WH., Kaplan LD. AIDS-related lymphoproliferative disease. Blood. 2006. 107:13–20.
crossref
3). Mounier N., Spina M., Gisselbrecht C. Modern management of non-Hodgkin lymphoma in HIV-in-fected patients. Br J Hematol. 2007. 136:685–98.
crossref
4). Folk GS., Abbondanzo SL., Childers EL., Foss RD. Plasmablastic lymphoma: a clinicopathologic correlation. Ann Diagn Pathol. 2006. 10:8–12.
crossref
5). Mounier N., Spina M., Gabarre J, et al. AIDS-related non-Hodgkin lymphoma: final analysis of 485 patients treated with risk-adapted intensive chemotherapy. Blood. 2006. 107:3832–40.
crossref
6). Besson C., Goubar A., Gabarre J, et al. Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood. 2001. 98:2339–44.
crossref
7). Delecluse HJ., Anagnostopoulos I., Dallenbach F, et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood. 1997. 89:1413–20.
crossref
8). Lin O., Gerhard R., Zerbini MC., Teruya-Feldstein J. Cytologic features of plasmablastic lymphoma. Cancer. 2005. 105:139–44.
crossref
9). Schichman SA., McClure R., Schaefer RF., Mehta P. HIV and plasmablastic lymphoma manifestating in sinus, testicles, and bones: a further expansion of the disease spectrum. Am J Hematol. 2004. 77:291–5.
10). Pruneri G., Graziadei G., Ermellino L., Baldini L., Neri A., Buffa R. Plasmablastic lymphoma of the stomach. A case report. Haematologica. 1998. 83:87–9.
11). Lin Y., Rodrigues GD., Turner JF., Vasef MA. Plasmablastic lymphoma of the lung: report of a unique case and review of the literature. Arch Pathol Lab Med. 2001. 125:282–5.
12). Choe PG., Song JS., Cho JH, et al. Malignancies in patients with human immunodeficiency virus infection in South Korea. Infect Chemother. 2006. 38:367–73.
13). Panos G., Karveli EA., Nikolatou O., Falagas ME. Prolonged survival of an HIV-infected patient with plasmablastic lymphoma of the oral cavity. Am J Hematol. 2007. 82:761–5.
crossref

Fig. 1
There was about 8.4×6.3cm sized slightly enhanced low density mass (arrow) in the anus and lower rectum and 7.4×5.9cm sized enhanced mass (arrow) in the pelvic cavity of left side (B).
kjh-43-198f1.tif
Fig. 2
(A) Histologic findings of perianal mass showed the diffuse proliferation of large atypical cells with starry sky pattern is seen in the submucosal layer (H&E stain, ×40). (B) Tumor cells had moderate amount of basophilic cytoplasm and eccentric nuclei with a prominent nucleolus (H&E stain, ×400). In immunohistochemical stains and in situ hybridization findings of perianal mass, each tumor cells were negative for CD20 (C) and positive for CD45 (D), CD138 (E), and EBER (F). (C, D, E: avidin-biotin complex method ×400; F: in situ hybridization, ×200).
kjh-43-198f2.tif
Fig. 3
PET-CT prior to chemotherapy (A) showed that hy-permetabolic lesions were involving in right parietal bone with destruction, sphenoid sinus, entire abdomen, left inguinal lesion and multiple bone lesions (both clavicle, both sternoclavicular junction, left humeral, both knee, both femur, left humeral head). And PET-CT after chemotherapy (B) revealed completely remitted status.
kjh-43-198f3.tif
TOOLS
Similar articles