Tissir Rajaa, Rais Hanan, Tazi Ilyas
Service d'Hématologie, CHU Mohammed VI, Université Cadi Ayyad, Marrakech, Maroc.
Service d'Anatomopathologie, CHU Mohammed VI, Université Cadi Ayyad, Marrakech, Maroc.
Pan Afr Med J. 2020 Sep 5;37:22. doi: 10.11604/pamj.2020.37.22.21352. eCollection 2020.
Plasmablastic lymphoma is an aggressive variant of lymphomas recently distinct from diffuse large B cell lymphoma. It has been initially described as a disease affecting the oral cavity of immunocompromised patients. We here report the first case of a 54-year-old patient with nasal septum nodule, bleeding on contact and after sneezing which occurred 6 months before admission. Facial computed tomography (CT) scan showed thickening of the nasal mucosa of 14mm. Excisional biopsy showed tumor proliferation composed of plasmablastic cells with immunophenotypic features: CD 138+, ki67 80%, EMA+, CD79a+, CD 56+. Staging and HIV serology were negative. Given the rarity of this lymphoma there are no standard treatments and most patients have treatment-resistant lymphoma with poor prognosis. Our patient received 6 cycles of CHOP-like chemotherapy associated with 40 gy radiotherapy in 20 fractions of 2 gy with complete remission (unusual in the cases described in the literature).
浆母细胞性淋巴瘤是一种最近才与弥漫性大B细胞淋巴瘤区分开来的侵袭性淋巴瘤变体。它最初被描述为一种影响免疫功能低下患者口腔的疾病。我们在此报告首例54岁患者，入院前6个月出现鼻中隔结节，接触及打喷嚏后出血。面部计算机断层扫描（CT）显示鼻黏膜增厚14毫米。切除活检显示肿瘤由具有免疫表型特征的浆母细胞组成：CD 138+、ki67 80%、EMA+、CD79a+、CD 56+。分期及HIV血清学检查均为阴性。鉴于这种淋巴瘤罕见，尚无标准治疗方法，大多数患者患有治疗抵抗性淋巴瘤，预后较差。我们的患者接受了6个周期类似CHOP的化疗，并联合40 Gy放疗，分20次，每次2 Gy，实现完全缓解（在文献报道的病例中不常见）。
