Oral Plasmablastic Lymphoma: A Case
Report of a HIV Negative Patient with
an Unusual Clinical Signature
Published: June 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/47321.15069
Pamela Pignatelli, Giulia Del Rosario, Luciano Cacchio, Adriano Piattelli, Michele Giuliani
1. Postdoctoral Fellow, Department of Medical, Oral and Biotechnological Sciences, University “G.D’Annunzio” of Chieti-Pescara Chieti, Italy.
2. Resident, Department of Pathology, "SS Annunziata" Hospital-ASL Chieti, Italy.
3. Senior Resident, Department of Odontostomatology, "SS Annunziata" Hospital-ASL Chieti, Italy.
4. Professor, Department of Medical, Oral and Biotechnological Sciences, University “G.D’Annunzio” of Chieti-Pescara Chieti, Italy.
5. Associate Professor, Department of Clinical and Experimental Medicine, University of Foggia, Italy.
Correspondence Address :
Pamela Pignatelli,
Via dei Vestini 31, Chieti, Italy.
E-mail: pamelapignatelli89p@gmail.com
Abstract
Plasmablastic Lymphoma (PBL) is an aggressive variant of diffuse large B-cell lymphoma with a low survival rate. It is associated with Human Immunodeficiency Virus (HIV) infection but also affects patients with autoimmune diseases as chronic lymphocytic leukaemia, systemic lupus erythematosus, with long-term immunosuppression for heart and kidney transplants and, ulcerative colitis. It has been reported in immunocompetent and HIV negative patients, determining the diagnosis more challenging. A rare case of bleeding gingival hyperplastic PBL in the left posterior mandibular area in a 61-year-old HIV negative male patient is reported. Histological assessment showed that oral mucosa was infiltrated by a monomorphic population of large lymphoid elements with morphological characteristics similar to immunoblasts with a “starry sky” appearance. Immunohistochemical markers were positive for CD138, Kappa and Lambda light chains, and negative for CKAE1/3, Synaptophysine, Chromogranin, CD56, and CD20. The detection of the primary oral manifestation of PBL remains challenging in immunocompetent patients and this case report aims to broaden the knowledge of the possible oral clinical aspects of PBL.
Keywords
Exophytic gingival lesion, Human immunodeficiency virus, Immunoblast, Non-hodgkin lymphoma, Spontaneous bleeding, Starry sky