1. Plasmablastic Lymphoma: A Multi-institutional Study and Review of the Literature
- Author
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Choudhuri, Jui, Pan, Zenggang, Yuan, Ji, Chen, Mingyi, Wu, Xiaojun, Zheng, Gang, Zhao, Chen, Yuan, Youzhong, Agarwal, Beamon, Liu, John, Ma, Maxwell Y., Wang, Yanhua, and Shi, Yang
- Subjects
Lymphomas -- Diagnosis ,Proteoglycans -- Health aspects ,Health - Abstract
Context.--Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma, usually positive for CD138 and frequently occurring in the oral cavity of human immunodeficiency virus (HIV) patients. Up to 10% of cases are negative for CD138 and diagnostically very challenging. Objective.--To investigate the appropriate approach to diagnose [CD138.sup.-] plasmablastic lymphoma and avoid misdiagnosis. Design.--We studied 21 cases of [CD138.sup.-] PBL from multiple large institutes in the United States and 21 cases from the literature. Results.--[CD138.sup.-] PBLs were positive for different B/ plasma cell markers at various percentages: MUM1 (94.4%; 34 of 36), OCT2 (70.6%; 12 of 17), immunoglobulin light chains (68.8%; 22 of 32), CD38 (68.4%; 13 of 19), CD79a (34.2%; 13 of 38), and PAX5 (15.6%; 5 of 32), suggesting that MUM1, OCT2, immunoglobulin light chains, and CD38 are useful markers to help establish the lineage. A total of 83% of cases (30 of 36) were extraoral lesions. Extraoral lesions showed much lower Epstein-Barr virus (EBV) infection rates (16 of 30; 53.3%) and had worse prognosis. MYC was positive in 80% (8 of 10) of [EBV.sup.+] cases and 40% (2 of 5) [EBV.sup.-] cases, indicating the importance of MYC in pathogenesis, especially in [EBV.sup.+] cases. Conclusions.--Our study emphasizes that [CD138.sup.-] PBLs tend to be extraoral lesions, with much lower EBV infection rates, and diagnostically very challenging. Accurate diagnosis requires a thorough investigation and workup by using appropriate markers. (Arch Pathol Lab Med. 2023;147:643-654; doi: 10.5858/arpa.2021-0462-OA), Plasmablastic lymphoma (PBL) is a diagnostic challenge in pathology, with morphologic and immunophenotypical features lying within the spectrum of diffuse large B-cell lymphoma and plasma cell myeloma. PBL was classified [...]
- Published
- 2023
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