Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area
| Autor: | Ewen D McAlpine, Pascale Willem, Shabnum Meer, Yvonne Perner |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Male Pathology medicine.medical_specialty Epstein-Barr Virus Infections Herpesvirus 4 Human Histology Adolescent HIV Infections Virus Pathology and Forensic Medicine Immunophenotyping Cohort Studies Proto-Oncogene Proteins c-myc 03 medical and health sciences South Africa Young Adult 0302 clinical medicine hemic and lymphatic diseases Plasma Cell Myeloma medicine Biomarkers Tumor Humans Child In Situ Hybridization Fluorescence Retrospective Studies CD20 biology business.industry HIV General Medicine Middle Aged CD79A medicine.disease Lymphoma 030104 developmental biology 030220 oncology & carcinogenesis biology.protein Plasmablastic Lymphoma Female business Diffuse large B-cell lymphoma Plasmablastic lymphoma |
| Zdroj: | HistopathologyReferences. 76(2) |
| ISSN: | 1365-2559 |
| Popis: | Aims Plasmablastic lymphoma (PBL) occurs mainly in immunocompromised individuals, usually secondary to human immunodeficiency virus (HIV) infection. It classically occurs intraorally, but has been described in extraoral locations. The aim of this study was to define the immunophenotype and Epstein-Barr virus (EBV) status in a large single-centre cohort of extraoral PBL (EPBL) in South Africa, a high-prevalence HIV setting. Methods and results This retrospective study of 45 EPBLs included patients' age, gender, race, HIV status, and site. Cases were reviewed histologically, and classified morphologically as pure plasmablastic or plasmablastic with plasmacytic differentiation, and assessed immunohistochemically with antibodies against CD45, CD20, CD79a, PAX5, CD138, MUM1/IRF4, BLIMP1, VS38c, Ki67, bcl-6, CD10, cyclin D1, and human herpesvirus-8, by the use of standard automated procedures. EBV was assessed by the use of chromogenic in-situ hybridisation. Tumours were assessed with a fluorescence in-situ hybridisation (FISH) MYC break-apart probe. Twenty-seven PBLs showed pure plasmablastic morphology, and 18 showed plasmacytic differentiation. The male/female ratio was 1.5:1. The anus was the favoured extraoral site (31.1%), followed by lymph nodes (15.6%). All 29 patients with known HIV status were HIV-positive. The immunohistochemical profile recapitulated that reported for oral PBLs and EPBLs in HIV-positive and HIV-negative patients. EBV was positive in 92.5% of PBLs. FISH analysis showed MYC rearrangement in 48% of cases. Conclusion This study showed a strong association of EPBLs with HIV and EBV infection, similarly to the previously described oral PBL. The strong EBV association together with other clinicopathological parameters and an immunohistochemical profile that includes CD45, CD20, MUM1/IRF4, CD138 and Ki67 may be used in distinguishing PBL from diffuse large B-cell lymphoma and plasma cell myeloma. |
| Databáze: | OpenAIRE |
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