A Case Report with Plasmablastic Lymphoma of the Jejunum

• Published in: Journal of Korean medical science Vol. 25; no. 3; pp. 496 - 500
• Main Authors: Cha, Jae Myung, Lee, Joung Il, Joo, Kwang Ro, Jung, Sung Won, Shin, Hyun Phil, Lee, Jae Jin, Kim, Gyo Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.03.2010; 대한의학회
• Subjects: Case Report; Diagnosis, Differential; Humans; Immunophenotyping; Jejunal Neoplasms - immunology; Jejunal Neoplasms - pathology; Jejunal Neoplasms - therapy; Jejunum - immunology; Jejunum - pathology; Lymphoma, Large-Cell, Immunoblastic - immunology; Lymphoma, Large-Cell, Immunoblastic - pathology; Lymphoma, Large-Cell, Immunoblastic - therapy; Male; Middle Aged; 의학일반; HIV-negative; Plasmablastic Lymphoma; Jejunum
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2010.25.3.496

Plasmablastic lymphoma (PBL) is a recently identified entity that is considered to be a type of diffuse large B-cell lymphoma with a unique immunophenotype and a predilection for the oral cavity of patients with the human immunodeficiency virus (HIV). Although its clinical features may help in the differential diagnosis, an extraoral location in a patient without HIV makes it more difficult to suspect clinically. This case report is the first to describe a patient with PBL originating from the jejunum in a 60-yr-old, HIV-seronegative man. Computed tomography of the face, chest and abdomen showed about a 9.4 x 9.0 cm mass of the proximal jejunum, multiple masses in the musculoskeletal soft tissue, and multiple lymphadenopathies. The histological examinations demonstrated a large cell lymphoma with plasmablastic differentiation. The neoplastic cells were diffusely positive for MUM1, epithelial membrane antigen and lambda light chains, and focally positive for CD79a; but negative for CD3, CD20, CD30, CD34, CD45RO, CD56, CD99, and CD117. The proliferation index by Ki-67 immunohistochemistry was approximately 70%. These findings were compatible with the diagnosis of PBL. The findings in this case suggest that PBL should be included in the differential diagnosis of a small bowel mass even in a HIV-negative patient.