Lymphoma & related disorders
Mature B cell neoplasms
Large B cell lymphomas-special subtypes
Plasmablastic lymphoma of oral mucosa type
Author: Nikhil Sangle, M.D.
Topic Completed: 1 March 2011
Minor changes: 1 April 2020
Copyright: 2001-2020, PathologyOutlines.com, Inc.
PubMed Search: plasmablastic lymphoma oral mucosa type
Table of Contents
Clinical features | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Molecular / cytogenetics images | Differential diagnosisCite this page: Sangle N. Plasmablastic lymphoma of oral mucosa type. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphomaplasmablastic.html. Accessed August 8th, 2020.
Clinical features
- Usually involves mucosa of oral cavity and jaw with local invasion and rapid dissemination to extraoral sites; also nasal cavity, paranasal sinuses, eyelid, orbit or occasionally other sites with similar morphology
- No serum monoclonal protein, no significant bone marrow involvement
- Usually HIV+ (73%), EBV+; occasionally HIV- but immunosuppressed or elderly patients without known immunodeficiency
- More common than non oral mucosal type
- Usually male, median age 48 years (range 11 - 86 years)
- Aggressive with poor prognosis (survival 1 - 16 months)
- Originates from plasmablast, a blastic B cell with phenotype switched to that of a plasma cell
- May be associated with Castleman disease
- Secondary cases are associated with another plasma cell neoplasm
- Variant with plasmacytic differentiation: no gender predominance; median age 55 years (range 30 - 86 years); nodal or extranodal; may occur in oral cavity; only 33% HIV+; usually BCL6 and HHV8 negative; also aggressive - most patients die in first year after diagnosis
Case reports
- 44 year old man with parotid gland tumor (Head Neck Pathol 2010;4:148)
- 47 year old HIV+ man with presentation as lung tumor (Arch Pathol Lab Med 2001;125:282)
- 51 year old man with 8 year history of HIV (Rare Tumors 2011;3:e11)
- 82 year old, HIV- man with cervical nodal tumor (Arch Pathol Lab Med 2004;128:581)
- Tumors with immunoblastic features in HIV+ patients with Kaposi sarcoma (Mod Pathol 2003;16:424)
Microscopic (histologic) description
- Monotonous proliferation of large lymphoid cells with immunoblastic features (abundant basophilic cytoplasm with occasional paranuclear hofs, open chromatin, prominent central nucleoli); cohesive tumor cells may resemble plasmablasts
- Tumor cells infiltrate in large cohesive masses with relatively well defined advancing edge
- Frequent mitotic figures, apoptotic cells, occasional tingible body macrophages, cells with plasmacytic features
- Variant with plasmacytic differentiation has predominance of immunoblasts and plasmablasts (rounded nuclei, coarse chromatin, smaller nuclei), also small cells with plasmacytic differentiation, and occasional binucleated cells with typical plasma cell cartwheel chromatin
Microscopic (histologic) images
Images hosted on other servers:
44 year old man with parotid gland tumor
47 year old HIV+ man with presentation as lung tumor
51 year old man with 8 year history of HIV
82 year old, HIV- man with cervical nodal tumor
Positive stains
Molecular / cytogenetics description
- Monoclonal immunoglobulin heavy chain gene rearrangement
Molecular / cytogenetics images
Images hosted on other servers:
PCR of IgH gene rearrangement
Differential diagnosis
- Burkitt lymphoma: CD20+
- Plasma cell myeloma: fewer blast-type cells, fewer mitotic figures, HHV8- (Am J Surg Pathol 2004;28:736)
