Oral and Extraoral Plasmablastic Lymphoma: Similarities and Differences in Clinicopathologic Characteristics

• Published in: American journal of clinical pathology 2010-11, Vol.134 (5), p.710-719
• Main Authors: HANSRA, Damien, MONTAGUE, Naomi, STEFANOVIC, Alexandra, AKUNYILI, Ikechukwu, HARZAND, Arash, NATKUNAM, Yasodha, DE LA OSSA, Margarita, BYRNE, Gerald E, LOSSOS, Izidore S
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Child, Preschool; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - pathology; HIV Infections - complications; HIV Infections - pathology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunohistochemistry; Immunopathology; In Situ Hybridization; Infectious diseases; Investigative techniques, diagnostic techniques (general aspects); Kaplan-Meier Estimate; Lymphoma, Large B-Cell, Diffuse - complications; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large-Cell, Immunoblastic - complications; Lymphoma, Large-Cell, Immunoblastic - pathology; Male; Medical sciences; Middle Aged; Mouth Mucosa - pathology; Mouth Neoplasms - complications; Mouth Neoplasms - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Plasma Cells - pathology; Retrospective Studies; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/AJCPJH6KEUSECQLU

Plasmablastic lymphoma (PBL), initially characterized as an aggressive lymphoma arising in the jaw and oral mucosa in HIV-infected patients, was recently reported to occur with extraoral manifestations, heterogeneous histologic findings, and variable association with immunodeficiency states. We reviewed clinical, morphologic, and immunophenotypic features of 13 cases of PBL to determine whether these different subtypes represent distinct morphologic and clinical entities. Two distinct subtypes of PBL were identified and classified as oral and extraoral PBL. The oral PBLs were strongly associated with HIV infection and commonly demonstrated plasmablastic morphologic features without plasmacytic differentiation. Extraoral PBLs tended to occur in patients with underlying non-HIV-related immunosuppression and universally demonstrated plasmacytic differentiation. The patients with oral PBL demonstrated better overall survival compared with patients with extraoral PBL (P = .02). Our findings suggest that PBL with oral and extraoral manifestation represent 2 distinct clinicopathologic entities.