Assuntos
Infecções por HIV , Linfoma Plasmablástico , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18 , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Boca/patologia , Infecções por HIV/complicações , Infecções por HIV/diagnóstico por imagem , Infecções por HIV/patologiaRESUMO
OBJECTIVE: The purpose of the current study was to report on the clinical presentation and radiological features of 72 cases of oral and maxillofacial plasmablastic lymphomas (PBL). METHODS: Histologically confirmed cases of PBL were retrospectively reviewed over a 10-year period. Demographic and clinical data were retrieved from the patient's records. Radiological information was obtained from the available radiographic examinations. RESULTS: The prevalence of PBL was 0.6% of diagnosed head and neck lesions. PBL presented at a mean age of 39 years, demonstrating a strong male predominance. All patients with a known retroviral disease (RVD) status were HIV-positive. PBL had a maxillary predilection (78%), with posterior regions of both jawbones most commonly affected (76%). Most cases had bony involvement (95%), with poorly demarcated bony borders seen in the majority of cases (93%). PBL had a tendency to cause a loss of cortical integrity (96%), either via cortical erosion or destruction, rather than cortical expansion (2%). CONCLUSION: Most of the current literature on PBL focuses on demographics, anatomical location, and histopathological profile, with radiological features only reported in isolated case reports. This study is the first of its kind to report on the clinicoradiological appearance of PBL in a large sample. These findings may assist clinicians in the clinical diagnostic work-up of patients, including the acquisition and assessment of appropriate advanced radiographic imaging.
Assuntos
Linfoma Plasmablástico , Adulto , Feminino , Humanos , Masculino , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Radiografia , Estudos RetrospectivosRESUMO
ABSTRACT: Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B-cell lymphoma which is associated with HIV infection. Recently, it has also been reported in immunocompetent and solid organ transplant patients. PBL commonly presents in extranodal regions such as oral cavity, digestive tract, and skin. Orbital involvement by PBL is extremely rare with only few reports in the literature. We present a case of PBL involving the bilateral orbits in an immunocompetent patient with 1-year follow-up on 18F-FDG PET/CT scan.
Assuntos
Infecções por HIV , Linfoma Difuso de Grandes Células B , Linfoma Plasmablástico , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Plasmablástico/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia ComputadorizadaAssuntos
Infecções por Vírus Epstein-Barr/tratamento farmacológico , Gengiva/patologia , Infecções por HIV/tratamento farmacológico , Mandíbula/patologia , Linfoma Plasmablástico/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Biópsia , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Infecções por Vírus Epstein-Barr/diagnóstico por imagem , Infecções por Vírus Epstein-Barr/patologia , Infecções por Vírus Epstein-Barr/virologia , Raios gama , Gengiva/diagnóstico por imagem , Gengiva/efeitos dos fármacos , Gengiva/virologia , HIV/efeitos dos fármacos , HIV/crescimento & desenvolvimento , Infecções por HIV/diagnóstico por imagem , Infecções por HIV/patologia , Infecções por HIV/virologia , Herpesvirus Humano 4/efeitos dos fármacos , Herpesvirus Humano 4/crescimento & desenvolvimento , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/efeitos dos fármacos , Mandíbula/virologia , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Linfoma Plasmablástico/virologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prednisona/uso terapêutico , Costelas/diagnóstico por imagem , Costelas/efeitos dos fármacos , Costelas/patologia , Costelas/virologia , Escápula/diagnóstico por imagem , Escápula/efeitos dos fármacos , Escápula/patologia , Escápula/virologia , Vincristina/uso terapêuticoRESUMO
INTRODUCTION: Plasmablastic lymphoma (PBL) is an uncommon and aggressive large B-cell lymphoma commonly diagnosed in human immunodeficiency viruses -positive patients. Oral cavity is the most commonly PBL affected site. Most oral PBLs presented as asymptomatic swellings, frequently associated with ulcerations and bleeding. Most cases lacked B-symptoms, suggesting a more local involvement of the disease. No standard treatment is yet for oral PBL. Five-year survival rate recorded no more than 33.5%. PATIENT CONCERNS: A 39-year-old male presented to Dental Clinic with 1 month swelling of the oral cavity, in absence of any other symptoms or signs. He followed antibiotic therapy just on suspicion of an oral abscess and later oral surgical treatment on suspicion of bone neoplasm. DIAGNOSIS: Surgical specimen analysis highlighted a diffuse infiltrate of large-sized atypical cells with plasmablastic appearance and plasma cell phenotype. Oral cavity PBL was diagnosed. Blood tests recorded mild lymphopenia and positive human immunodeficiency viruses serology. INTERVENTIONS: Patient underwent chemotherapy including intrathecal methotrexate prophylaxis, in addition to a highly active antiretroviral therapy. OUTCOMES: At 12 months from diagnosis, patient recorded complete hematological remission. CONCLUSIONS: Oral PBL diagnosis requires a high level of suspicion and awareness both by physicians and pathologists. They should be aware of the extent of such disease which is often mistaken as oral abscess or infected tooth, thus leading to delay the most appropriate diagnostic evaluation. As PBL is an aggressive non-Hodgkin lymphoma, a delayed diagnosis might negatively impact on both treatment and survival.
Assuntos
Antineoplásicos/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Boca/patologia , Linfoma Plasmablástico/tratamento farmacológico , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Adulto , Assistência ao Convalescente , Antibacterianos/uso terapêutico , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/uso terapêutico , Quimioterapia Combinada , Edema/etiologia , Infecções por HIV/complicações , Soropositividade para HIV/sangue , HIV-1/imunologia , Humanos , Injeções Espinhais , Linfoma não Hodgkin/patologia , Masculino , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Plasmócitos/patologia , Linfoma Plasmablástico/diagnóstico por imagem , Resultado do TratamentoRESUMO
We describe an exceptionally rare case of a male patient with newly diagnosed advanced human immunodeficiency virus (HIV) infection, who presented with a plasmablastic lymphoma involving the right maxillary alveolar ridge with associated cervical lymphadenopathy. On a staging positron emission tomography computed tomography (PET-CT) scan, he was incidentally found to have an endotracheal tumour involving the anterolateral aspect of the mid-trachea. The tumour appeared to be well-vascularised at bronchoscopy and was confirmed as well-differentiated plasmablastic lymphoma. Plasmablastic lymphoma is a rare form of non-Hodgkin lymphoma and is associated with HIV. Tracheal involvement to the extent seen in our patient is exceptionally rare, and, to the best of our knowledge, has never been described.
Assuntos
Infecções por HIV/diagnóstico , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/terapia , Neoplasias da Traqueia/diagnóstico por imagem , Neoplasias da Traqueia/terapia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica , Biópsia por Agulha , Broncoscopia/métodos , Terapia Combinada , Seguimentos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Imuno-Histoquímica , Masculino , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Linfoma Plasmablástico/complicações , Linfoma Plasmablástico/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Radioterapia Adjuvante , Doenças Raras , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/patologia , Resultado do TratamentoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Implantes de Mama/efeitos adversos , Linfoma Plasmablástico/tratamento farmacológico , Literatura de Revisão como Assunto , Idoso , Feminino , Humanos , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia ComputadorizadaAssuntos
Antígeno B7-H1/antagonistas & inibidores , Nivolumabe/uso terapêutico , Linfoma Plasmablástico/tratamento farmacológico , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Adulto , Aloenxertos , Antineoplásicos Imunológicos/uso terapêutico , Antígeno B7-H1/metabolismo , Resistencia a Medicamentos Antineoplásicos , Tratamento Farmacológico/métodos , Feminino , Humanos , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Receptor de Morte Celular Programada 1/metabolismo , Transplante de Células-Tronco/métodos , Resultado do TratamentoAssuntos
Neoplasias Encefálicas , Plasmócitos , Linfoma Plasmablástico , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Feminino , Humanos , Plasmócitos/metabolismo , Plasmócitos/patologia , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/metabolismo , Linfoma Plasmablástico/patologia , Linfoma Plasmablástico/terapiaRESUMO
PURPOSE: Plasmablastic lymphoma (PBL) is a rare variant of diffuse large B cell lymphomas (DLBCL) clinically characterized by a poorer prognostic. Few clinical and imaging data are available and derived from pooled case reports and small series. The aim of the study was to evaluate the FDG avidity at baseline and the utility of 18-Fluorodeoxyglucose (FDG) positron-emission-tomography/computed-tomography (PET/CT) for staging and response assessment. METHODS: Patients with newly diagnosed PBL seen at Lymphoma Study Association centers during the period 2005-2015 were included if they underwent a PET/CT at staging and at the end of treatment (eotPET) and had received an anthracycline-based first line therapy. EotPET scans were analyzed using the 5-point-scale visual analysis in accordance with Lugano criteria. Patients were classified in complete metabolic response (CMR) or no-CMR including partial metabolic response (PMR), stable disease (SD) and progression disease (PD). EotPET results were assessed for the ability to predict event free survival (EFS) and overall survival (OS). RESULTS: Thirty-five PBL patients fulfilled the inclusion criteria. The median follow-up was 34 months (2.8-120 months). FDG avidity was found in all patients at diagnosis. Most patients (80%) achieved CMR, and 20% were no-CMR including 9% PMR, 6% SD, and 6% PD. A CMR after first line chemotherapy predicted higher EFS (p < 0.0001) and OS (p = 0.0006). CONCLUSIONS: This study confirmed the FDG avidity of PBL subtype and the usefulness of PET/CT scanning in restaging an aggressive lymphoma at the completion of chemotherapy. EotPET can predict outcomes following treatment in patients with PBL.
Assuntos
Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/terapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Adulto JovemRESUMO
A 73-year-old woman had a diagnosis of a plasmablastic lymphoma by the excision of the right parotid gland. Two years after the diagnosis, the patient underwent a whole-body C-methionine PET/CT in order to evaluate the amino acid avidity of a scalp metastasis and for plasmablastic lymphoma restaging. C-methionine uptake was detected in the scalp, in several bone sites, and in the cricoid cartilage. Plasmablastic lymphoma is a subtype of B-cell lymphoma with an aggressive behavior and a poor prognosis. C-methionine appears to be a promising tracer for paraprotein-producing neoplasms.
Assuntos
Radioisótopos de Carbono , Metionina , Linfoma Plasmablástico/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Idoso , Feminino , HumanosAssuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical , Linfoma Plasmablástico/terapia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistência a Medicamentos , Resistencia a Medicamentos Antineoplásicos , Infecções por Vírus Epstein-Barr , Feminino , Soronegatividade para HIV , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/tratamento farmacológico , Linfoma Plasmablástico/virologia , Indução de Remissão , Condicionamento Pré-Transplante/métodosRESUMO
BACKGROUND: Plasmablastic lymphoma (PBL) is an uncommon variant of diffuse large B-cell lymphoma that is characterized by its plasmacytoid features, aggressive tendencies, and frequent association with human immunodeficiency virus (HIV) infection or other immunocompromised states. Multi-agent, intensive chemotherapy regimens are recommended as first-line treatment by the National Comprehensive Cancer Network. However, the toxicity of these regimens is high and prognosis remains poor. CASE REPORT: We report a patient with HIV-negative PBL who achieved complete response and durable remission using a lenalidomide-based chemotherapy regimen as first-line therapy. CONCLUSION: Cyclophosphamide, lenalidomide, dexamethasone (CRD) may provide an alternative initial therapeutic option for patients with PBL who cannot tolerate the intensive chemotherapy regimens currently recommended.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Dexametasona/uso terapêutico , Linfoma Plasmablástico/tratamento farmacológico , Neoplasias do Colo Sigmoide/tratamento farmacológico , Talidomida/análogos & derivados , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada , Infecções por Vírus Epstein-Barr/diagnóstico , Soronegatividade para HIV , Humanos , Lenalidomida , Masculino , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Prognóstico , Indução de Remissão , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/patologia , Talidomida/uso terapêuticoRESUMO
BACKGROUND: Primary intracranial plasmablastic lymphoma (PIPBL) is a rare malignant tumor. CASE DESCRIPTION: We present a case of PIPBL in a 32-year-old man who complained of a progressive growing, painful mass on the right parieto-occipital part of head. Computed tomography and magnetic resonance imaging revealed a homogeneously enhanced mass with partial bone destruction. The patient underwent total resection and cranioplasty in one stage. Histopathologic examination showed large tumor cells with immunoblast-like nuclei. Immunohistochemical staining displayed CD38(+), CD138(+), Mum-1(+), CD20(-), and PAX-5(-). The patient received chemotherapy. The patient has survived more than 3.5 years after operation, with follow-up. We also review the clinical data, molecular pathologic traits, treatment, and prognosis of additional 6 cases with PIPBL in the literature. CONCLUSIONS: This study provides important clinical information for the diagnosis and treatment of PIPBL.
Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Procedimentos Neurocirúrgicos/métodos , Linfoma Plasmablástico/patologia , Linfoma Plasmablástico/cirurgia , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Diagnóstico Diferencial , Intervalo Livre de Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Linfoma Plasmablástico/diagnóstico por imagem , Taxa de SobrevidaAssuntos
Adenocarcinoma/diagnóstico , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/patologia , Neoplasias do Colo Sigmoide/diagnóstico , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Humanos , Masculino , Linfoma Plasmablástico/cirurgia , Doenças Raras/diagnóstico por imagem , Doenças Raras/patologia , Doenças Raras/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Plasmablastic lymphoma is a variant of diffuse large B-cell lymphoma, characterized by rapid progression and is associated with a poor outcome. We report a 35-year-old male with poorly controlled HIV infection and AIDS who presented with skin lesions and swelling throughout the body. Computed tomography (CT) revealed innumerable enhancing soft tissue masses within the subcutaneous soft tissues and lymphadenopathy. Plasmablastic lymphoma was diagnosed, patient was treated with chemotherapy, and post treatment CT demonstrated complete resolution. Imaging plays a key role in the diagnosis and surveillance of this disease.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Linfoma Plasmablástico , Neoplasias Cutâneas , Pele , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica , Infecções por HIV/complicações , Humanos , Linfoma Relacionado a AIDS/diagnóstico , Linfoma Relacionado a AIDS/diagnóstico por imagem , Linfoma Relacionado a AIDS/tratamento farmacológico , Linfoma Difuso de Grandes Células B , Masculino , Linfoma Plasmablástico/diagnóstico por imagem , Linfoma Plasmablástico/tratamento farmacológico , Linfoma Plasmablástico/etiologia , Indução de Remissão , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/etiologia , Tomografia Computadorizada por Raios X/métodosRESUMO
BACKGROUND: It has been known that plasmablastic lymphoma (PBL) is a neoplasm of immunocompromised patients occurring in soft tissue of oral cavity or in the vicinity whereas bone is an unlikely site to harbor PBL. However, its occurrence is increasingly being reported in immunocompetent individuals in either osseous or extra-oral sites. To our best knowledge, F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient have not been reported, yet . CASE SUMMARY: We report a case of PBL involving multiple bones in an immunocompetent patient. Features of different imaging modalities including F-18 Fluoro-deoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) were correlated well as findings of osteosarcoma in mandible with metastatic lesions. However, the histopathology and immunohistochemistry (IHC) of bone tissues from 2 separate biopsy sites revealed features of PBL. CONCLUSION: awareness to F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient may prevent misdiagnosis.