Human Immunodeficiency Virus Associated Plasmablastic Lymphoma Involving Bones and Peritoneum in a 4-Year-old Child

Area of Science:

• Pediatric Oncology
• Hematology
• Infectious Diseases

Background:

• Hematolymphoid cancers, particularly non-Hodgkin lymphomas, are prevalent in children with Human Immunodeficiency virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS).
• Plasmablastic lymphoma (PBL) is an aggressive non-Hodgkin lymphoma subtype, typically affecting the head and neck region, and is exceptionally rare in pediatric populations.
• The occurrence of PBL in extranodal sites, such as the knee joint in HIV-infected children, presents a diagnostic and therapeutic challenge.

Observation:

• A 4-year-old boy with an underlying Human Immunodeficiency virus infection presented with a solitary bony swelling localized to the right knee joint.
• Diagnostic investigations confirmed the swelling to be a case of plasmablastic lymphoma, an unusual presentation for this specific malignancy in a pediatric patient.
• The patient's clinical course was meticulously monitored following diagnosis.

Findings:

• The diagnosis of plasmablastic lymphoma was established through comprehensive work-up of the knee joint swelling.
• The child received a treatment regimen comprising combination chemotherapy and intrathecal chemotherapy.
• Highly active anti-retroviral therapy (HAART) was initiated early in conjunction with cancer-directed treatment.

Implications:

• This case highlights the importance of considering rare presentations of plasmablastic lymphoma in immunocompromised children.
• The successful outcome underscores the efficacy of a multimodal treatment approach, including chemotherapy and early HAART, in managing pediatric plasmablastic lymphoma.
• Further research into the specific oncogenesis and optimal management strategies for extranodal plasmablastic lymphoma in HIV-infected children is warranted.