PLASMABLASTIC LYMPHOMA WITH SECONDARY ORAL MANIFESTATION: A CASE REPORT

Abstract

Plasmablastic lymphoma (PbL) is an uncommon and aggressive B-cell malignancy highly prevalent among individuals with human immunodeficiency virus (HIV). We report the case of a 26-year-old male patient, recently diagnosed with both HIV and PbL after 10 days of daily fever episodes, bilateral sharp pain in the frontal region of the face, and swelling of the right periorbital region. During hospitalization for the first chemotherapy cycle, a purple nodular lesion on the right anterior superior gingiva and ulceration of the right hard palate were observed by the dental team. An incisional biopsy was performed. Microscopically, the tumor showed diffuse proliferation of medium- to large-sized atypical cells with plasmacytic differentiation, which were strongly positive for CD138/MUM-1, focally positive for CD10/BCL2, and negative for CD20/CD3/CD56/CD30/BCL6. Ki-67 labeling index was 90% and in situ hybridization for Epstein-Barr encoded RNA revealed infection of most peripheral blood lymphocytes cells by Epstein-Barr virus. The final diagnosis was PbL with oral involvement. Plasmablastic lymphoma (PbL) is an uncommon and aggressive B-cell malignancy highly prevalent among individuals with human immunodeficiency virus (HIV). We report the case of a 26-year-old male patient, recently diagnosed with both HIV and PbL after 10 days of daily fever episodes, bilateral sharp pain in the frontal region of the face, and swelling of the right periorbital region. During hospitalization for the first chemotherapy cycle, a purple nodular lesion on the right anterior superior gingiva and ulceration of the right hard palate were observed by the dental team. An incisional biopsy was performed. Microscopically, the tumor showed diffuse proliferation of medium- to large-sized atypical cells with plasmacytic differentiation, which were strongly positive for CD138/MUM-1, focally positive for CD10/BCL2, and negative for CD20/CD3/CD56/CD30/BCL6. Ki-67 labeling index was 90% and in situ hybridization for Epstein-Barr encoded RNA revealed infection of most peripheral blood lymphocytes cells by Epstein-Barr virus. The final diagnosis was PbL with oral involvement.