[Plasmablastic lymphoma presenting with plasmacytosis and polyclonal hypergammopathy]

Area of Science:

• Oncology
• Hematology
• Infectious Disease

Background:

• Plasmablastic lymphoma is an aggressive non-Hodgkin lymphoma often associated with the Epstein-Barr virus.
• It predominantly affects immunocompromised individuals, particularly those with advanced HIV infection.

Observation:

• A 72-year-old woman presented with generalized lymphadenopathy, plasmacytosis, and polyclonal hypergammaglobulinemia.
• FDG-PET imaging revealed widespread involvement of lymph nodes, spleen, and bones.
• Histopathology of lymph nodes showed a monotonous plasma cell population positive for CD19, lambda light chains, and Epstein-Barr virus-encoded RNA, with a high MIB-1 index.

Findings:

• The patient was diagnosed with plasmablastic lymphoma.
• Epstein-Barr virus was detected in the tumor cells.
• The lymphoma showed a high proliferation rate (MIB-1 index 80%).

Implications:

• This case highlights the importance of considering plasmablastic lymphoma in older adults presenting with atypical lymphoproliferative disorders, even in the absence of HIV.
• Successful treatment with dose-adjusted EPOCH chemotherapy offers a potential therapeutic strategy for this aggressive lymphoma.
• Further research is warranted to understand the pathogenesis and optimize treatment for EBV-associated lymphomas.