Plasmablastic Lymphoma in a Previously Undiagnosed Human Immunodeficiency Virus-Positive Patient: A Case Report

Year 2023, , 92 - 95, 04.09.2023

Nelli Yıldırımyan , Ayşe Taş , Selmi Yılmaz , Mehmet Ali Altay

https://doi.org/10.17214/gaziaot.1177114

Abstract

Plasmablastic lymphoma (PBL) is a rare and aggressive non-Hodgkin lymphoma subtype associated with human immunodeficiency virus (HIV) infection. PBL is extremely aggressive and has a poor response to treatment. Clinically PBL resembles a periodontal disease, Kaposi sarcoma, or melanoma. Delayed diagnosis adversely affects the treatment and life expectancy. A 52-year-old male presented with a firm intraoral mass causing a slight elevation noticeable extraorally. Radiologically, loss of lamina dura around the first premolar and loss of both vertical and horizontal bone height around the dental implant replacing the second premolar were present. The biopsy confirmed a diagnosis of PBL. Further evaluation revealed that the patient was positive for HIV. The chemotherapy regimen included etoposide, vincristine, hydroxydaunorubicin, cyclophosphamide, and prednisolone, followed by an autologous hematopoietic stem cell bone marrow transplant. This article attempts to describe the clinical presentation and histopathological evaluation of PBL, and emphasize the paramount role of biopsy, early clinical suspicion, and correct diagnosis.

Keywords

Plasmablastic lymphoma, human immunodeficiency virus, gingival enlargement, oral cavity

Supporting Institution

None

Project Number

Not applicable

Daha Önce Tanı Almamış İnsan İmmünyetmezlik Virüsü Pozitif Hastada Plazmablastik Lenfoma: Bir Olgu Sunumu

Abstract

Plazmablastik lenfoma (PBL), insan immünyetmezlik virüsü (HIV) enfeksiyonu ile ilişkili nadir ve agresif bir Hodgkin-olmayan lenfoma (NHL) alt tipidir. PBL son derece agresif bir seyir gösterir ve tedaviye zayıf yanıt verir. Klinik olarak PBL; periodontal hastalık, Kaposi sarkomu veya melanomaya benzeyebilir. Geç tanı, tedaviyi ve yaşam beklentisini olumsuz etkiler. Bu olgu sunumu, sol maksillada hem bukkal hem de palatal tarafta premolar dişleri çevreleyen ve ekstraoral belirgin hafif bir yükselmeye neden olan sert hemisferik bir kitle şikayeti ile başvuran 52 yaşında erkek bir hastayı rapor etmektedir. Birinci premolar çevresinde lamina dura kaybına ve ikinci premoların yerini alan dental implant çevresinde hem dikey hem de yatay kemik yüksekliğinin kaybına ilişkin radyolojik kanıtlar izlenmiştir. Histolojik incelemede biyopsi örneği PBL tanısını doğrulamıştır. Daha sonraki değerlendirmede hastanın HIV pozitif olduğu ortaya çıkmıştır. Kemoterapi rejimi etoposid, vinkristin, hidroksidaunorubisin, siklofosfamid ve prednizolon (EPOCH) ve ardından otolog hematopoietik kök hücre kemik iliği naklini içermiştir. Bu makale PBL'nin klinik sunumunu ve şüpheli gingival büyümelerde biyopsi ve histopatolojik değerlendirmenin önemli rolünü vurgulamaya çalışmaktadır.

Keywords

Plazmablastik lenfoma, insan immünyetmezlik virüsü, diş eti büyümesi, ağız boşluğu

Project Number

Not applicable

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