Zhou Jiehao, Nassiri Mehdi
From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis.
Arch Pathol Lab Med. 2022 Apr 1;146(4):407-414. doi: 10.5858/arpa.2021-0117-RA.
CONTEXT.—: Plasmablastic morphology can be seen in several uncommon lymphoproliferative neoplasms. Sometimes it is difficult to distinguish these neoplasms from each other.
OBJECTIVE.—: To review the current understanding of major lymphoproliferative neoplasms with plasmablastic morphology; summarize the clinical, morphologic, immunophenotypic, cytogenetic, and molecular characteristics of each disease entity; and highlight a practical approach for differential diagnosis.
DATA SOURCES.—: Peer-reviewed medical literature and the authors' personal experience.
CONCLUSIONS.—: Plasmablastic lymphoma; plasmablastic myeloma; primary effusion lymphoma; human herpesvirus 8-positive diffuse large B-cell lymphoma, not otherwise specified; and anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma are major lymphoproliferative neoplasms with plasmablastic morphology. These neoplasms share many common morphologic and immunophenotypic characteristics. Definitive diagnosis requires a thorough understanding of disease phenotype and diagnostic criteria of each category. Recognition of expression pattern of Epstein-Barr virus-encoded small RNA, human herpesvirus 8, and ALK in these neoplasms is critical for diagnosis in cases with typical presentation. Additional ancillary studies and clinical findings may help in difficult cases.
浆母细胞形态可见于几种罕见的淋巴增殖性肿瘤。有时难以将这些肿瘤彼此区分开来。
回顾目前对具有浆母细胞形态的主要淋巴增殖性肿瘤的认识；总结每种疾病实体的临床、形态学、免疫表型、细胞遗传学和分子特征；并强调一种实用的鉴别诊断方法。
同行评审的医学文献和作者的个人经验。
浆母细胞淋巴瘤、浆母细胞骨髓瘤、原发性渗出性淋巴瘤、未另行指定的人疱疹病毒8阳性弥漫性大B细胞淋巴瘤以及间变性淋巴瘤激酶（ALK）阳性大B细胞淋巴瘤是具有浆母细胞形态的主要淋巴增殖性肿瘤。这些肿瘤具有许多共同的形态学和免疫表型特征。明确诊断需要全面了解每种类型的疾病表型和诊断标准。认识这些肿瘤中爱泼斯坦-巴尔病毒编码的小RNA、人疱疹病毒8和ALK的表达模式对于典型表现病例的诊断至关重要。在疑难病例中，额外的辅助研究和临床发现可能会有所帮助。
