TY - JOUR
T1 - CD138- Plasmablastic Lymphoma A Multi-institutional Study and Review of the Literature
AU - Choudhuri, Jui
AU - Pan, Zenggang
AU - Yuan, Ji
AU - Chen, Mingyi
AU - Wu, Xiaojun
AU - Zheng, Gang
AU - Zhao, Chen
AU - Yuan, Youzhong
AU - Agarwal, Beamon
AU - Liu, John
AU - Ma, Maxwell Y.
AU - Wang, Yanhua
AU - Shi, Yang
N1 - Publisher Copyright:
© 2023 College of American Pathologists. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - Context.—Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma, usually positive for CD138 and frequently occurring in the oral cavity of human immunodeficiency virus (HIV) patients. Up to 10% of cases are negative for CD138 and diagnostically very challenging. Objective.—To investigate the appropriate approach to diagnose CD138- plasmablastic lymphoma and avoid misdiagnosis. Design.—We studied 21 cases of CD138- PBL from multiple large institutes in the United States and 21 cases from the literature. Results.—CD138- PBLs were positive for different B/ plasma cell markers at various percentages: MUM1 (94.4%; 34 of 36), OCT2 (70.6%; 12 of 17), immunoglobulin light chains (68.8%; 22 of 32), CD38 (68.4%; 13 of 19), CD79a (34.2%; 13 of 38), and PAX5 (15.6%; 5 of 32), suggesting that MUM1, OCT2, immunoglobulin light chains, and CD38 are useful markers to help establish the lineage. A total of 83% of cases (30 of 36) were extraoral lesions. Extraoral lesions showed much lower Epstein-Barr virus (EBV) infection rates (16 of 30; 53.3%) and had worse prognosis. MYC was positive in 80% (8 of 10) of EBVþ cases and 40% (2 of 5) EBV- cases, indicating the importance of MYC in pathogenesis, especially in EBVþ cases. Conclusions.—Our study emphasizes that CD138- PBLs tend to be extraoral lesions, with much lower EBV infection rates, and diagnostically very challenging. Accurate diagnosis requires a thorough investigation and workup by using appropriate markers.
AB - Context.—Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma, usually positive for CD138 and frequently occurring in the oral cavity of human immunodeficiency virus (HIV) patients. Up to 10% of cases are negative for CD138 and diagnostically very challenging. Objective.—To investigate the appropriate approach to diagnose CD138- plasmablastic lymphoma and avoid misdiagnosis. Design.—We studied 21 cases of CD138- PBL from multiple large institutes in the United States and 21 cases from the literature. Results.—CD138- PBLs were positive for different B/ plasma cell markers at various percentages: MUM1 (94.4%; 34 of 36), OCT2 (70.6%; 12 of 17), immunoglobulin light chains (68.8%; 22 of 32), CD38 (68.4%; 13 of 19), CD79a (34.2%; 13 of 38), and PAX5 (15.6%; 5 of 32), suggesting that MUM1, OCT2, immunoglobulin light chains, and CD38 are useful markers to help establish the lineage. A total of 83% of cases (30 of 36) were extraoral lesions. Extraoral lesions showed much lower Epstein-Barr virus (EBV) infection rates (16 of 30; 53.3%) and had worse prognosis. MYC was positive in 80% (8 of 10) of EBVþ cases and 40% (2 of 5) EBV- cases, indicating the importance of MYC in pathogenesis, especially in EBVþ cases. Conclusions.—Our study emphasizes that CD138- PBLs tend to be extraoral lesions, with much lower EBV infection rates, and diagnostically very challenging. Accurate diagnosis requires a thorough investigation and workup by using appropriate markers.
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U2 - 10.5858/arpa.2021-0462-OA
DO - 10.5858/arpa.2021-0462-OA
M3 - Article
C2 - 36161544
AN - SCOPUS:85160968896
SN - 0003-9985
VL - 147
SP - 643
EP - 654
JO - Archives of Pathology and Laboratory Medicine
JF - Archives of Pathology and Laboratory Medicine
IS - 6
ER -