Blood Res.  2025;60:22. 10.1007/s44313-025-00070-w.

Frequent association of malignant effusions in plasmablastic lymphoma: a single‑institutional experience of nine cases in Taiwan

• Chen B
• Kuo Y
• Chang S
• Win K
• Chen S
• Hsiao S
• Feng Y
• Hsieh Y
• Chuang S

• KMID: 2567133
• DOI: http://doi.org/10.1007/s44313-025-00070-w

Abstract

Purpose
Plasmablastic lymphoma (PBL) is a rare, aggressive lymphoma that is characterized by terminal B-cell differ‑ entiation. In the West, PBL usually occurs in patients with immunodeficiencies, particularly those induced by human immunodeficiency virus (HIV) infection. We investigated the clinicopathological features of PBL at a single institute in Taiwan, where HIV infection is rare.
Methods
This retrospective chart review identified PBL cases that were treated at a single institute in southern Tai‑ wan between 2008 and 2024.
Results
We identified nine patients (four males and five females; median age 71 years). Of the eight patients tested for HIV, only one tested positive. Pathologically, the tumors showed plasmablastic morphology and immunopheno‑ type, and three (33%) cases tested positive for Epstein–Barr virus. Six (67%) patients presented with Stage IV disease, including five (56%) with malignant effusion. Six patients were treated with chemotherapy and the remaining three received only supportive care. During a median follow-up of 10 months, five patients died of progressive disease, two died of unrelated diseases, and two were alive with PBL relapse.
Conclusion
In Taiwan, PBL constitutes a rare and aggressive clinical condition and is frequently associated with malignant effusion. In contrast to Western patients, the PBL in most patients from Taiwan was unrelated to HIV infection.

Keyword

EBV; HIV; Malignant effusion; Multiple myeloma; Plasmablastic lymphoma

Figure

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  Fig. 1 A 41-year-old, HIV-infected male patient (Patient no. 9) underwent imaging studies after diagnosis. Post-contrast-enhanced coronal CT images of the abdomen (A) and axial CT images of the lower chest (B) demonstrate a large volume of ascites and bilateral pleural effusions (*). An enlarged para-aortic lymph node (arrow) and peritoneal nodular thickening (arrowheads) are observed. Partial collapse of the left lower lobe of the lung is also noted

• 

  Fig. 2 A representative case of plasmablastic lymphoma (Patient no. 8). The patient presented with disseminated disease and pleural effusion. Effusion cytology from cytospun smear shows numerous discohesive tumor cells with vesicular nuclei and slightly irregular nuclear contours and the majority with a single prominent nucleolus (A × 400 and B × 1000; Papanicolaou stain). C–F, Trans-urethral resection specimen of the urinary bladder shows a diffuse lymphomatous infiltration with focal tumor necrosis (C; HE stain × 100). The tumor cells are large with vesicular nuclei, prominent nucleoli, and a moderate amount of eosinophilic to amphophilic cytoplasm (D; HE stain × 1,000). The tumor cells diffusely express CD38 (E; immunohistochemical stain × 400) and MYC (F; × 400), but not CD20 (not shown), and tested negative for EBV on in situ hybridization (not shown)

Reference

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