Teruya-Feldstein J, Chiao E, Filippa D A, Lin O, Comenzo R, Coleman M, Portlock C, Noy A
Department of Pathology, Memorial Sloan-Kettering Cancer Center, NY 10021, USA.
Ann Oncol. 2004 Nov;15(11):1673-9. doi: 10.1093/annonc/mdh399.
Plasmablastic lymphoma (PBL) has been described as a rapidly progressive and almost invariably fatal CD20- VS38c+ diffuse large-cell lymphoma with plasmablastic features, almost exclusively involving the jaw and oral mucosa in HIV-positive patients.
From 2001 to 2003 we evaluated 12 men with PBL, and report the pathology, clinical findings, treatment and outcome. Six of 12 were HIV-positive while among the others, one was post-renal transplant, one had ulcerative colitis and four had no known immunodeficiency.
Tumor growth pattern, in general, showed cohesiveness and a starry-sky pattern; the morphology varied from typical plasmablastic to centroblastic cells. Partial immunophenotypes were (+/total): CD138, 11 of 12 (91.7%); MIB1 10 of 11 (4+, range 75-95%); p63/VS38c, nine of 10 (90%); EBV, eight of 11 (73%); LCA(CD45), two of 12 (16.7%); HHV8/LANA, zero of 10; ALK, zero of seven; and CD20, zero of 12. Three had stage IE and nine stage IV disease. Nine of 12 had an intermediate/high International Prognostic Index or high-risk disease. Computed tomography and positron emission tomography scan in four of 12 revealed extensive bone metastases. Eight of 12 are alive after treatment, with a median follow-up of 11+ months (range 1-24). Of the HIV-positive patients, five of six are alive with a median follow-up of 17 months.
It appears that PBL are heterogenous in terms of clinical presentation and morphology. The outcome presented here is superior to that originally reported.
浆母细胞淋巴瘤（PBL）被描述为一种具有浆母细胞特征的快速进展且几乎总是致命的CD20 - VS38c +弥漫大细胞淋巴瘤，几乎仅累及HIV阳性患者的颌骨和口腔黏膜。
2001年至2003年，我们评估了12例患有PBL的男性患者，并报告了其病理、临床发现、治疗及预后情况。12例患者中6例为HIV阳性，其他患者中，1例为肾移植后患者，1例患有溃疡性结肠炎，4例无已知免疫缺陷。
肿瘤生长模式总体上表现为黏附性和星空模式；形态从典型的浆母细胞到中心母细胞不等。部分免疫表型为（阳性/总数）：CD138，12例中的11例（91.7%）；MIB1，11例中的10例（4 +，范围75 - 95%）；p63/VS38c，10例中的9例（90%）；EBV，11例中的8例（73%）；LCA(CD45)，12例中的2例（16.7%）；HHV8/LANA，10例中的0例；ALK，7例中的0例；以及CD20，12例中的0例。3例为IE期，9例为IV期疾病。12例中的9例具有中等/高国际预后指数或高危疾病。12例中的4例进行计算机断层扫描和正电子发射断层扫描显示有广泛的骨转移。12例中有8例在治疗后存活，中位随访时间为11 +个月（范围1 - 24个月）。在HIV阳性患者中，6例中有5例存活，中位随访时间为17个月。
看来PBL在临床表现和形态方面是异质性的。此处呈现的预后优于最初报道的情况。
