Plasmablastic lymphoma: case report

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Plasmablastic lymphoma (PBL) is a high-grade non-Hodgkin lymphoma.
• It predominantly affects individuals with HIV infection, transplant recipients, and the elderly.
• The oral cavity is the most common site, with neoplastic cells expressing plasma cell markers (CD138, CD38) and often associated with Epstein-Barr virus.

Purpose of the Study:

• To highlight the diagnostic challenges of plasmablastic lymphoma, particularly differentiating it from multiple myeloma.
• To present a case study of a patient with HIV and symptoms suggestive of myeloma.

Main Methods:

• Diagnostic workup included protein electrophoresis and bone marrow aspiration to rule out multiple myeloma.
• A bone biopsy confirmed plasmablastic lymphoma, positive for CD138, high Ki-67 (80%), and Epstein-Barr virus.
• Treatment involved EPOCH chemotherapy combined with antiretroviral therapy.

Main Results:

• The patient presented with symptoms mimicking myeloma-related organ dysfunction.
• Despite initial investigations ruling out multiple myeloma, a bone biopsy confirmed plasmablastic lymphoma.
• The patient received EPOCH chemotherapy, achieving a survival of six months.

Conclusions:

• Distinguishing plasmablastic lymphoma from multiple myeloma is critical due to overlapping features.
• A comprehensive diagnostic approach integrating clinical, biochemical, immunohistochemical, and radiographic data is essential.
• Effective treatment involves EPOCH chemotherapy and antiretroviral therapy, improving survival rates.