Plasmablastic Lymphoma Mimicking Acute Pancreatitis

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Plasmablastic lymphoma (PBL) is a rare, aggressive B-cell neoplasm.
• It typically affects the oral cavity of human immunodeficiency virus (HIV)-positive patients.
• PBL exhibits a highly aggressive clinical behavior.

Purpose of the Study:

• To report an unusual case of PBL presenting as acute pancreatitis.
• To highlight the importance of considering PBL in the differential diagnosis of pancreatic masses.
• To emphasize the diagnostic challenges and treatment response in such cases.

Main Methods:

• Histopathological examination of peripancreatic masses.
• Immunohistochemical staining for B-cell markers (BOB1, MUM1, CD79a, CD20, CD138).
• Epstein-Barr virus-encoded RNA (EBER) in situ hybridization.

Main Results:

• A 37-year-old HIV-positive male presented with acute pancreatitis due to peripancreatic masses.
• Histopathology revealed large B-cells consistent with PBL.
• The neoplastic cells were positive for BOB1 and MUM1, and EBER in situ hybridization was positive.
• The patient responded well to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy.

Conclusions:

• This is the first reported case of PBL presenting initially with acute pancreatitis.
• PBL should be considered in the differential diagnosis of pancreatic and peripancreatic tumors, especially in HIV-positive individuals.
• Prompt diagnosis and appropriate chemotherapy, such as CHOP, can lead to a favorable response.