Plasmablastic lymphoma in HIV+ patients: an expanding spectrum
Plasmablastic lymphoma in HIV+ patients: an expanding spectrum
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DOI：
10.1046/j.1365-2559.2003.01636.x
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发表时间：
2003-06-01
期刊：
影响因子：
6.4
通讯作者：
Gatter, K
中科院分区：
文献类型：
--
作者：
Chetty, R;Hlatswayo, N;Gatter, K
目的：描述一种罕见部位的人类免疫缺陷病毒（HIV）相关淋巴瘤。浆母细胞淋巴瘤是一种独特的艾滋病毒相关肿瘤，最早在颌骨和口腔中描述。只有两例（胃和肺）已被记录在口外sites.Materials和Methods：四例中遇到HIV+患者：三个在肛门直肠区域和一个是鼻和鼻旁。结果：本组病例均表现为高度恶性的母细胞型非霍奇金淋巴瘤的典型形态学表现（核分裂活跃，巨噬细胞体易染）。此外，一些细胞具有浆细胞样外观和核旁清除。免疫表型上，肿瘤细胞对LCA、CD20和CD45RA呈阴性。然而，一小部分细胞（5%）对CD79a呈免疫反应性，大多数对VS38c呈阳性，表明浆细胞分化。Kappa轻链和IgG重链限制性也determined.Conclusions：浆母细胞淋巴瘤可能发生在口腔外的网站，并有一个特征性的免疫表型，包括局灶性表达的CD31的肿瘤细胞。认识到缺乏表达的传统B细胞标志物，其存在于不寻常的网站应有助于诊断浆母细胞淋巴瘤的HIV+患者。
Aim: To describe an unusual human immunodeficiency virus (HIV)-associated lymphoma in uncommon sites. Plasmablastic lymphoma is a distinctive HIV-associated tumour that was first described in the jaws and oral cavity. Only two cases (stomach and lung) have been documented in extra-oral sites.Materials and methods: Four cases were encountered in HIV+ patients: three in the anorectal region and one which was nasal and paranasal. The cases were routinely processed and immunohistochemistry was performed on formalin-fixed paraffin-embedded tissue.Results: The cases showed the typical morphological appearances of a high-grade, blastic non-Hodgkin's lymphoma (brisk mitotic activity and tingible body macrophages). In addition, some cells had a plasmacytoid appearance and paranuclear clearing. Immunophenotypically, the tumour cells were negative for LCA, CD20 and CD45RA. However, a small proportion of cells (5%) were immunoreactive for CD79a and the majority were positive with VS38c, indicative of plasma cell differentiation. Kappa light chain and IgG heavy chain restriction was also detected.Conclusions: Plasmablastic lymphoma may occur in extra-oral sites and has a characteristic immunophenotype including focal expression of CD31 by the neoplastic cells. Awareness of the absence of expression of conventional B-cell markers and its presence in unusual sites should facilitate the diagnosis of plasmablastic lymphoma in HIV+ patients.