Plasmablastic Lymphoma: The 'Rare' Frequency Among Immunocompromised Patients

Abstract

Limfoproliferations associated with HIV infection/AIDS are rare conditions, with an incidence of malignant lymphomas of approximately 10% among the 25-40% malignancies that can occur in these immunosuppressed patients (1). Plasmablastic lymphoma (PBL), with an incidence of only 2% (out of the total lymphomas), is a borderline form (morphologically and immunophenotypically) between lymphoma and myeloma, defined by its high aggressiveness and unfavorable prognosis (2). Objectives: identifying the clinical, histopathological, and biological characteristics of PBL that require a differential diagnosis within other malignant hematological conditions associated with HIV infection. Materials and Methods: We present three comparative cases of PBL that were observed at the Colțea Hematology Clinic in a short time window (4 months). All patients were diagnosed with PBL in the context of HIV/AIDS infection, with an average age of approximately 41 years, predominantly male (66.6%), and with a symptomatology onset characteristic of immunocompromised individuals (manifesting at the oral, lymph node, and cutaneous levels), but with specific aspects related to associated comorbidities (e.g., psychiatric pathology, dilated cardiomyopathy), risk behaviors (e.g., intravenous drug use for 20 years), and infectious/ non-infectious complications, which influenced the patients' evolution. Conclusions: Plasmablastic lymphoma still represents a highly aggressive condition with an unfavorable prognosis, possibly having a higher clinical incidence than that described in the literature and requiring a adequate multidisciplinary approach.