Plasmablastic lymphoma of the oral cavity: a rapidly progressive lymphoma associated with HIV infection

• Published in: The Lancet infectious diseases 2008-04, Vol.8 (4), p.261-267
• Main Authors: Riedel, David J, Dr, Gonzalez-Cuyar, Luis F, MD, Zhao, X Frank, MD, Redfield, Robert R, MD, Gilliam, Bruce L, MD
• Format: Article
• Language: English
• Subjects: Adult; Anti-HIV Agents - therapeutic use; Antineoplastic Agents - therapeutic use; Antiretroviral agents; Biological and medical sciences; Biopsy; Diagnosis, Differential; Head - diagnostic imaging; Hematologic and hematopoietic diseases; HIV Infections - complications; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious Disease; Infectious diseases; Lesions; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma; Lymphoma, AIDS-Related - diagnosis; Lymphoma, AIDS-Related - pathology; Lymphoma, AIDS-Related - physiopathology; Lymphoma, AIDS-Related - therapy; Male; Medical sciences; Mouth - pathology; Mouth Neoplasms - diagnosis; Mouth Neoplasms - pathology; Mouth Neoplasms - physiopathology; Mouth Neoplasms - therapy; Tomography, X-Ray Computed; Toothache - etiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(08)70067-7

Summary Plasmablastic lymphoma of the oral cavity is a form of non-Hodgkin lymphoma (NHL) and was first described in 1997. We describe a case of plasmablastic lymphoma in an HIV-infected patient who presented with an expanding oral lesion and symptoms of a toothache. We review all cases of plasmablastic lymphoma that have been reported in the literature. Plasmablastic lymphoma is strongly associated with immunodeficiency, and most particularly, with HIV infection. The pathophysiological origin of plasmablastic lymphoma has not been fully characterised, but the presence of Epstein-Barr virus (EBV) has often been documented in biopsy specimens, supporting a role for EBV in the pathogenesis of this lymphoma. The differential diagnosis for an expanding oral lesion includes both infectious and malignant processes. Biopsy is essential for making a correct and prompt diagnosis. Treatment usually involves chemotherapy, but antiretroviral therapy may also have an important role. Infectious disease clinicians should be aware of this newly described and increasingly encountered lymphoma, since it is prominently associated with immunosuppression and may be mistaken for other entities.