Pant Ved Prakash, Dallakoti Nishanta, Kc Priyanka, Mishra Akshat, Pokharel Sandip, Adhikari Purbesh, Dulal Soniya
B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Ann Med Surg (Lond). 2022 May 11;78:103750. doi: 10.1016/j.amsu.2022.103750. eCollection 2022 Jun.
Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B cell lymphoma characterized by weak or absent expression of conventional B cell markers and strong expression of plasma cell markers. Very few cases of PBL of the colon have been reported in HIV negative patients.
A 57 years female with HIV negative serology, a known case of hypertension under medication presented with right lower abdominal pain associated with vomiting and significant weight loss. On abdominal examination, soft, tender, and globular lump was palpable. Contrast enhanced computed tomography of abdomen and pelvis revealed asymmetrical enhancing mass like wall thickening involving ileocaecal region, caecum, and ascending colon, which on colonoscopy was found to be ulceroproliferative in nature. Open right hemicolectomy was performed and postoperative histopathology and immunohistochemistry results confirmed plasmablastic lymphoma as the final diagnosis. She was treated with nine cycles of chemotherapy.
Although PBL is commonly found in the oral cavity, and HIV positive patients, it can rarely occur in extra-oral sites, and HIV negative patients. Due to its rarity, no optimal therapeutic approach has yet been defined for the treatment of PBL. It has a poor prognosis, and the overall survival rate has been correlated with international prognostic index score and achievement of complete remission.
As plasmablastic lymphoma is rare and highly aggressive, its delayed diagnosis will lead to poor outcome. Thus, awareness about its clinical presentation, histopathological features, and immunophenotype is essential.
浆母细胞性淋巴瘤（PBL）是弥漫性大B细胞淋巴瘤的一种罕见且侵袭性变体，其特征为传统B细胞标志物表达减弱或缺失，而浆细胞标志物表达强烈。在HIV阴性患者中，结肠PBL的病例报道极少。
一名57岁女性，HIV血清学阴性，有高血压病史且正在服药，出现右下腹痛，伴有呕吐和显著体重减轻。腹部检查时，可触及柔软、压痛的球形肿块。腹部和盆腔增强CT显示，回盲部、盲肠和升结肠区域有不对称强化的肿块样肠壁增厚，结肠镜检查发现其本质为溃疡增生性病变。遂行右半结肠切除术，术后组织病理学和免疫组化结果确诊为浆母细胞性淋巴瘤。患者接受了9个周期的化疗。
尽管PBL常见于口腔及HIV阳性患者，但也极少发生于口腔外部位及HIV阴性患者。由于其罕见性，目前尚未确定PBL的最佳治疗方法。其预后较差，总体生存率与国际预后指数评分及完全缓解的实现情况相关。
由于浆母细胞性淋巴瘤罕见且侵袭性强，其诊断延迟会导致不良预后。因此，了解其临床表现、组织病理学特征和免疫表型至关重要。
