Academic Journal
Atypical Plasmablastic Lymphoma Presenting as a Perianal Mass in a 19-Year-Old Male
| العنوان: | Atypical Plasmablastic Lymphoma Presenting as a Perianal Mass in a 19-Year-Old Male |
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| المؤلفون: | Ding, Daniel, Wang, Jun |
| المصدر: | American Journal of Clinical Pathology ; volume 152, issue Supplement_1, page S110-S111 ; ISSN 0002-9173 1943-7722 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2019 |
| الوصف: | Objectives To describe a case of plasmablastic lymphoma with an atypical immunophenotype in an unusual location. Methods We received this specimen for routine processing after the patient underwent an incision and drainage surgery. The specimen was sent to hematopathology for workup of lymphoma. We then ordered several special stains and molecular tests to confirm our diagnosis of plasmablastic lymphoma. Results Histologic examination of the tissue reveals sheets of large plasmablastic cells with eccentrically located round nuclei, prominent nucleoli, and cartwheel chromatin. Frequent apoptotic bodies and mitotic figures are present. Immunohistochemistry shows strong, diffuse positivity for leukocyte common antigen CD45, CD10, plasmacytic markers (MUM1, CD79a) and negativity for B-cell markers (CD20, PAX5) and CD138. The Ki-67 proliferation index is very high (>90%) and Epstein-Barr virus encoded small RNA (EBER) in situ hybridization is diffusely positive. Molecular FISH testing for aggressive B-cell lymphoma genetic abnormalities is positive for MYC gene rearrangement in 68% of nuclei and the loss of one copy of the BCL2 gene on chromosome 18 in 64% of nuclei. Conclusion This case of plasmablastic lymphoma is unique due to its atypical presentation as a perianal mass in a young patient with undiagnosed HIV. Usually, this lymphoma presents as an oral lesion in an older patient with HIV. In addition, immunohistochemistry showed an unusual immunophenotype (CD138–, MUM1+, CD45+, CD10+). Most plasmablastic lymphomas are CD138+, MUM1+, and CD45– but this specimen is CD138–, MUM1+, and CD45+. Further testing shows EBER positivity, a positive HIV test, and MYC gene rearrangement, which confirms our diagnosis of a plasmablastic lymphoma. Of note, genetic analysis also reveals a loss of one copy of the BCL2 gene on chromosome 18 in 64% of nuclei. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/ajcp/aqz121.015 |
| الاتاحة: | https://doi.org/10.1093/ajcp/aqz121.015 http://academic.oup.com/ajcp/article-pdf/152/Supplement_1/S110/29968398/aqz121.015.pdf |
| Rights: | https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| رقم الانضمام: | edsbas.18450B69 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ajcp/aqz121.015 |
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