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Plasmablastic lymphomas of the oral cavity: a new entity associated with
the human immunodeficiency virus infection
HJ Delecluse, I Anagnostopoulos, F Dallenbach, M Hummel, T Marafioti, U Schneider, D Huhn, A Schmidt-Westhausen, PA Reichart, U Gross and H Stein
Institute of Pathology, Klinikum Benjamin Franklin, Free University of
Berlin, Germany.
We report here a series of 16 highly malignant diffuse large B-cell
lymphomas of the oral cavity with unique immunohistologic features. Fifteen
of these developed in human immunodeficiency virus-positive patients. All
cases displayed morphologic features of diffuse large- cell lymphomas but
strikingly differed from them in that they showed a minimal or absent
expression of the leukocyte common antigen as well as of the B-cell antigen
CD20. Instead, the tumor cells showed a constant reaction with the plasma
cell characteristic antibody VS38c and a frequent reaction with the CD79a
antibody. This, in conjunction with a variable expression of cytoplasmic Ig
and a monoclonal rearrangement of the Ig heavy chain gene in all of the
three tested cases confirmed the B-cell nature, the clonal origin, and the
plasmacellular differentiation of these neoplasms. The majority of these
tumors were negative for the BCL-6 protein, with the remaining cases
showing only a partial and weak expression of this antigen. An association
with the Epstein-Barr virus (EBV) was found in 9 of 15 tested cases showing
abundant EBV-encoded nuclear RNA transcripts in the absence of EBNA-2. Five
of the EBV-positive cases variably expressed LMP-1. We propose to name
these tumors plasmablastic lymphomas, in accordance with their morphologic
and immunohistologic features. Knowledge of this lymphoma entity is
important to avoid confusion with nonlymphoid malignancies due to the lack
of commonly used lymphoid markers.
Volume 89,
Issue 4,
pp. 1413-1420,
02/15/1997
Copyright © 1997 by The American Society of Hematology
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