Mani D, Jr DGG, Aboulafia DM. AIDS-associated plasmablastic lymphoma presenting as a poorly differentiated esophageal tumor: A diagnostic dilemma. World J Gastroenterol 2008; 14(27): 4395-4399 [PMID: 18666332 DOI: 10.3748/wjg.14.4395]
Corresponding Author of This Article
David M Aboulafia, MD, Division of Hematology, University Of Washington, Section of Hematology/Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, PO Box 900 (C2-HEM), Seattle, Washington WA 98111, United States. hemdma@vmmc.org
Article-Type of This Article
Case Report
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World J Gastroenterol. Jul 21, 2008; 14(27): 4395-4399 Published online Jul 21, 2008. doi: 10.3748/wjg.14.4395
AIDS-associated plasmablastic lymphoma presenting as a poorly differentiated esophageal tumor: A diagnostic dilemma
Deepthi Mani, Donald G Guinee Jr, David M Aboulafia
Deepthi Mani, David M Aboulafia, Division of Hematogy and Oncology, Virginia Mason Medical Center, Seattle, Washington WA 98111, United States
Deepthi Mani, Internal Medicine Residency, Spokane Medical centers, Spokane, Washington 99204, United States
Donald G Guinee Jr, Division of Pathology, Virginia Mason Medical Center, Seattle, Washington WA 98111, United States
David M Aboulafia, Division of Hematology, University Of Washington, Seattle, Washington WA 98111, United States
Author contributions: Mani D wrote the manuscript, Aboulafia DM critically revised the manuscript; Guinee DG Jr performed the pathological examination, provided the slides and revised the manuscript.
Correspondence to: David M Aboulafia, MD, Division of Hematology, University Of Washington, Section of Hematology/Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, PO Box 900 (C2-HEM), Seattle, Washington WA 98111, United States. hemdma@vmmc.org
Telephone: +1-206-2236193
Fax: +1-206-2236914
Received: February 20, 2008 Revised: May 30, 2008 Accepted: June 6, 2008 Published online: July 21, 2008
Abstract
Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associated with human immunodeficiency virus (HIV) and Epstein Barr virus infection, and shows an unusual tropism to the oral cavity. Herein we describe a patient with AIDS who presented with weight loss and dysphagia owing to a large gastroesophageal mass. His radiographic and endoscopic findings and long history of cigarette consumption suggested carcinoma. Biopsy demonstrated a poorly differentiated tumor stained negatively to routine lymphoid markers including CD20. However, gene rearrangement studies confirmed a B-cell process and a more detailed immunohistochemical analysis revealed the cells stained positively for CD138 (plasma cell antigen). These findings were diagnostic of PBL. Our report reviews the wide differential diagnosis of PBL and underscores the importance of a broad array of viral and molecular studies needed to establish this diagnosis.
