Korean J Hematol.  2008 Sep;43(3):198-202. 10.5045/kjh.2008.43.3.198.

Plasmablastic Lymphoma Mistaken for Perianal Abscess in Patient with AIDS

• Lee SC
• Kim HJ
• Bae SB
• Kim CK
• Lee NS
• Lee KT
• Park SK
• Hong DS
• Park HS
• Jin SY
• Won JH

• KMID: 2252190
• DOI: http://doi.org/10.5045/kjh.2008.43.3.198

Abstract

Patients with acquired immunodeficiency virus (AIDS) are at increased risk for B-cell neoplasms and plasma cell dyscrasias. Plasmablastic lympomas (PBLs) were originally described exclusively in HIV-positive patients who presented with jaw or oral mucosa involvement. Recent studies report that this neoplasm also occurs in patients without HIV infection and may involve sites other than the head and neck. Until now, only sinus, oral mucosa, bone, testicles, gastrointestinal and pulmonary manifestations have been reported. In this report we describe a 41-year-old male with AIDS who mistook plasmablastic lymphoma of the pelvic cavity for perianal abscess. The patient presented with multiple involvement of bone and highly aggressive progression of pelvic mass without the involvement of bone marrow.

Keyword

Plasmablastic lymphoma; Acquired immunodeficiency syndrome; Abscess; Perianal

MeSH Terms

Abscess
Acquired Immunodeficiency Syndrome
Adult
B-Lymphocytes
Head
HIV Infections
Humans
Jaw
Lymphoma
Male
Mouth Mucosa
Neck
Paraproteinemias
Testis
Viruses

Figure

• 

  Fig. 1 There was about 8.4×6.3cm sized slightly enhanced low density mass (arrow) in the anus and lower rectum and 7.4×5.9cm sized enhanced mass (arrow) in the pelvic cavity of left side (B).

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  Fig. 2 (A) Histologic findings of perianal mass showed the diffuse proliferation of large atypical cells with starry sky pattern is seen in the submucosal layer (H&E stain, ×40). (B) Tumor cells had moderate amount of basophilic cytoplasm and eccentric nuclei with a prominent nucleolus (H&E stain, ×400). In immunohistochemical stains and in situ hybridization findings of perianal mass, each tumor cells were negative for CD20 (C) and positive for CD45 (D), CD138 (E), and EBER (F). (C, D, E: avidin-biotin complex method ×400; F: in situ hybridization, ×200).

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  Fig. 3 PET-CT prior to chemotherapy (A) showed that hy-permetabolic lesions were involving in right parietal bone with destruction, sphenoid sinus, entire abdomen, left inguinal lesion and multiple bone lesions (both clavicle, both sternoclavicular junction, left humeral, both knee, both femur, left humeral head). And PET-CT after chemotherapy (B) revealed completely remitted status.

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