Plasmablastic lymphoma: Cytologic findings in 5 cases with unusual presentation.

Michelle Reid-Nicholson, Sravankumar Kavuri, Celalettin Ustun, Jennifer Crawford, Asha Nayak-Kapoor, Preetha Ramalingam

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin lymphoma that was once believed to occur primarily in the oral cavity of human immunodeficiency virus-positive individuals. Numerous extraoral sites have also been reported to date. To the authors' knowledge, however, only 3 reports in the literature describe its cytologic features. In the current study, the cytologic findings in 5 additional patients are reported, 3 of whom had concomitant second malignancies. The goal of the current study was to define the cytomorphologic features that may help to distinguish PBL from other mimics. METHODS: Five cases were identified from the pathology files for which cytology was available. The presence of the following was evaluated: cellularity, plasmablastic cells, background necrosis (BN), single-cell necrosis (SCN), lymphoglandular bodies (LGB), tingible-body macrophages (TBM), 3-dimensional clusters/sheets, and cytoplasmic vacuoles. RESULTS: The patients included 3 women and 2 men with an age range of 40 to 57 years. Two patients had the acquired immunodeficiency syndrome and 3 had second non-PBL related malignancies including endometrial carcinoma, lung adenocarcinoma, and small lymphocytic lymphoma. The most common cytologic features were hypercellularity (80%), plasmablastic cells (73%), SCN (73%), BN (87%), and LGB (66%). TBMs (33%) and clusters/sheets (47%) were the least common features. CONCLUSIONS: Although no 1 cytologic feature is diagnostic of PBL, a constellation of findings should raise suspicion. These include hypercellular specimens with abundant plasmablastic cells, LGB, SCN, and BN. However, although these findings may suggest PBL, a definitive diagnosis requires adjunctive studies including immunohistochemistry and flow cytometry. As with any lymphocyte-rich aspirate, additional material should be collected for these studies. Over-reliance on adjuvant studies is discouraged because the PBL immunophenotype is not considered standard. (c) 2008 American Cancer Society.

Original languageEnglish (US)
Pages (from-to)333-341
Number of pages9
JournalCancer
Volume114
Issue number5
DOIs
StatePublished - Oct 25 2008

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Necrosis
Second Primary Neoplasms
B-Cell Chronic Lymphocytic Leukemia
Endometrial Neoplasms
Vacuoles
Non-Hodgkin's Lymphoma
Cell Biology
Mouth
Plasmablastic Lymphoma
Lymphoma
Flow Cytometry
Acquired Immunodeficiency Syndrome
Immunohistochemistry
Macrophages
HIV
Lymphocytes
Pathology
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Plasmablastic lymphoma : Cytologic findings in 5 cases with unusual presentation. / Reid-Nicholson, Michelle; Kavuri, Sravankumar; Ustun, Celalettin; Crawford, Jennifer; Nayak-Kapoor, Asha; Ramalingam, Preetha.

In: Cancer, Vol. 114, No. 5, 25.10.2008, p. 333-341.

Research output: Contribution to journalArticle

Reid-Nicholson, M, Kavuri, S, Ustun, C, Crawford, J, Nayak-Kapoor, A & Ramalingam, P 2008, 'Plasmablastic lymphoma: Cytologic findings in 5 cases with unusual presentation.', Cancer, vol. 114, no. 5, pp. 333-341. https://doi.org/10.1002/cncr.23794
Reid-Nicholson, Michelle ; Kavuri, Sravankumar ; Ustun, Celalettin ; Crawford, Jennifer ; Nayak-Kapoor, Asha ; Ramalingam, Preetha. / Plasmablastic lymphoma : Cytologic findings in 5 cases with unusual presentation. In: Cancer. 2008 ; Vol. 114, No. 5. pp. 333-341.
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title = "Plasmablastic lymphoma: Cytologic findings in 5 cases with unusual presentation.",
abstract = "BACKGROUND: Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin lymphoma that was once believed to occur primarily in the oral cavity of human immunodeficiency virus-positive individuals. Numerous extraoral sites have also been reported to date. To the authors' knowledge, however, only 3 reports in the literature describe its cytologic features. In the current study, the cytologic findings in 5 additional patients are reported, 3 of whom had concomitant second malignancies. The goal of the current study was to define the cytomorphologic features that may help to distinguish PBL from other mimics. METHODS: Five cases were identified from the pathology files for which cytology was available. The presence of the following was evaluated: cellularity, plasmablastic cells, background necrosis (BN), single-cell necrosis (SCN), lymphoglandular bodies (LGB), tingible-body macrophages (TBM), 3-dimensional clusters/sheets, and cytoplasmic vacuoles. RESULTS: The patients included 3 women and 2 men with an age range of 40 to 57 years. Two patients had the acquired immunodeficiency syndrome and 3 had second non-PBL related malignancies including endometrial carcinoma, lung adenocarcinoma, and small lymphocytic lymphoma. The most common cytologic features were hypercellularity (80{\%}), plasmablastic cells (73{\%}), SCN (73{\%}), BN (87{\%}), and LGB (66{\%}). TBMs (33{\%}) and clusters/sheets (47{\%}) were the least common features. CONCLUSIONS: Although no 1 cytologic feature is diagnostic of PBL, a constellation of findings should raise suspicion. These include hypercellular specimens with abundant plasmablastic cells, LGB, SCN, and BN. However, although these findings may suggest PBL, a definitive diagnosis requires adjunctive studies including immunohistochemistry and flow cytometry. As with any lymphocyte-rich aspirate, additional material should be collected for these studies. Over-reliance on adjuvant studies is discouraged because the PBL immunophenotype is not considered standard. (c) 2008 American Cancer Society.",
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AU - Nayak-Kapoor, Asha

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AB - BACKGROUND: Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin lymphoma that was once believed to occur primarily in the oral cavity of human immunodeficiency virus-positive individuals. Numerous extraoral sites have also been reported to date. To the authors' knowledge, however, only 3 reports in the literature describe its cytologic features. In the current study, the cytologic findings in 5 additional patients are reported, 3 of whom had concomitant second malignancies. The goal of the current study was to define the cytomorphologic features that may help to distinguish PBL from other mimics. METHODS: Five cases were identified from the pathology files for which cytology was available. The presence of the following was evaluated: cellularity, plasmablastic cells, background necrosis (BN), single-cell necrosis (SCN), lymphoglandular bodies (LGB), tingible-body macrophages (TBM), 3-dimensional clusters/sheets, and cytoplasmic vacuoles. RESULTS: The patients included 3 women and 2 men with an age range of 40 to 57 years. Two patients had the acquired immunodeficiency syndrome and 3 had second non-PBL related malignancies including endometrial carcinoma, lung adenocarcinoma, and small lymphocytic lymphoma. The most common cytologic features were hypercellularity (80%), plasmablastic cells (73%), SCN (73%), BN (87%), and LGB (66%). TBMs (33%) and clusters/sheets (47%) were the least common features. CONCLUSIONS: Although no 1 cytologic feature is diagnostic of PBL, a constellation of findings should raise suspicion. These include hypercellular specimens with abundant plasmablastic cells, LGB, SCN, and BN. However, although these findings may suggest PBL, a definitive diagnosis requires adjunctive studies including immunohistochemistry and flow cytometry. As with any lymphocyte-rich aspirate, additional material should be collected for these studies. Over-reliance on adjuvant studies is discouraged because the PBL immunophenotype is not considered standard. (c) 2008 American Cancer Society.

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