Rare and varied presentations of plasmablastic lymphoma: A case series

Plasmablastic lymphoma is a rare and aggressive variant of diffuse large B-cell lymphoma characterized by heterogeneous clinical presentations and poor outcomes. This study presents a comprehensive review integrated with three cases demonstrating diverse clinical manifestations and treatment outcomes. We conducted a detailed analysis of three plasmablastic lymphoma cases diagnosed and treated at our institution between 2022 and 2023, incorporating clinical presentations, diagnostic findings, treatment approaches, and outcomes. These cases were analyzed in the context of current literature and treatment guidelines. The cases included an HIV-positive male with perianal plasmablastic lymphoma, an HIV-negative female with gastric plasmablastic lymphoma arising from marginal zone lymphoma, and an HIV-negative female with retroperitoneal plasmablastic lymphoma. Two patients achieved complete remission with bortezomib plus dose-adjusted-etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin therapy, while one experienced treatment failure and death. Epstein-Barr virus positivity was observed in two cases. Treatment-related complications included peripheral neuropathy and organ failure. The cases demonstrated variable outcomes independent of HIV status but correlating with age and performance status. Our series highlights the diverse presentation patterns of plasmablastic lymphoma and validates known prognostic factors while demonstrating the efficacy of contemporary treatment approaches. The outcomes underscore the importance of individualized therapy and careful patient selection for intensive treatment regimens.