Limits...
Unusual presentation of duodenal plasmablastic lymphoma in an immunocompetent patient: A case report and literature review.

Cao C, Liu T, Lou S, Liu W, Shen K, Xiang B - Oncol Lett (2014)

Bottom Line: To the best of our knowledge, this is the first study to report a case of duodenal PBL in an immunocompetent patient.Therefore, PBL represents a diagnostic and therapeutic challenge.PBL must be considered in the differential diagnosis of gastrointestinal tumors in daily practice, even in immunocompetent patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China ; Department of Hematology, West China Hospital, Sichuan University, Key Laboratory of Hematology of Sichuan Province, Chengdu, Sichuan 610041, P.R. China.

ABSTRACT
Plasmablastic lymphoma (PBL) is a rare and recently described entity of large B-cell lymphoma. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior without effective treatment. Recently, sporadic cases describing PBL in extraoral locations of HIV-negative patients have been reported; frequently in patients with underlying immunosuppressive states. To develop the understanding of PBL, the current study reports the unusual presentation of duodenal PBL and reviews the pathogenesis, immunohistochemical features, clinical and differential diagnoses, as well as the treatment of PBL as described in previous studies. The case of a 75-year-old female with duodenal PBL without definite immunosuppression is presented in the current report. The tumor was composed of large B-cell-like cells, and was positive for cluster of differentiation 138 and melanoma ubiquitous mutated-1, with ~80% of the tumor cells positive for Ki-67. The features of the tumor were as follows: Extraoral location, HIV-negative, immunoglobulin M λ-type M protein expression, light chain restriction (monoclonal) and Epstein-Barr virus-encoded small RNA-negative, which are considered to be unusual for PBL. These unusual features complicate the differentiation of PBL from other plasma cell diseases. To the best of our knowledge, this is the first study to report a case of duodenal PBL in an immunocompetent patient. To date, the standard treatment of PBL remains elusive, however, the most commonly administered chemotherapy treatments are CHOP [intravenous cyclophosphamide (750 mg/m(2), day 1), intravenous doxorubicin (50 mg/m(2), day 1), intravenous vincristine (1.4 mg/m(2), day 1) and prednisone (100 mg, days 1-50)]-like regimens. The patient was administered two cycles of CHOP chemotherapy for 56 days, however, ultimately succumbed as a result of disease progression. Therefore, PBL represents a diagnostic and therapeutic challenge. PBL must be considered in the differential diagnosis of gastrointestinal tumors in daily practice, even in immunocompetent patients. Furthermore, CHOP does not appear to be an optimal treatment regimen and more intensive regimens are required.

No MeSH data available.


Related in: MedlinePlus

Abdominal computed tomography scan providing sequencing images at (A) diagnosis and (B) following one month of treatment. (A) MRI scan shwoing mass lesions in the wall of the gastric antrum and duodenal bulb, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions. (B) Following treatment the abdominal mass enlarged with extensive lymph node metastasis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4214469&req=5

f1-ol-08-06-2539: Abdominal computed tomography scan providing sequencing images at (A) diagnosis and (B) following one month of treatment. (A) MRI scan shwoing mass lesions in the wall of the gastric antrum and duodenal bulb, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions. (B) Following treatment the abdominal mass enlarged with extensive lymph node metastasis.

Mentions: The esophagogastroduodenoscopy revealed an ulcer in the duodenal bulb, measuring 1.2×1.5 cm in size, as well as mild chronic non-specific inflammation of the gastric antrum. An enhanced computed tomography scan of the abdomen (Fig. 1) showed mass lesions in the wall of the gastric antrum, duodenal bulb and descending segment, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions (Fig. 1A). A biopsy of the ulcer mass was conducted via an endoscopy.


Unusual presentation of duodenal plasmablastic lymphoma in an immunocompetent patient: A case report and literature review.

Cao C, Liu T, Lou S, Liu W, Shen K, Xiang B - Oncol Lett (2014)

Abdominal computed tomography scan providing sequencing images at (A) diagnosis and (B) following one month of treatment. (A) MRI scan shwoing mass lesions in the wall of the gastric antrum and duodenal bulb, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions. (B) Following treatment the abdominal mass enlarged with extensive lymph node metastasis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214469&req=5

f1-ol-08-06-2539: Abdominal computed tomography scan providing sequencing images at (A) diagnosis and (B) following one month of treatment. (A) MRI scan shwoing mass lesions in the wall of the gastric antrum and duodenal bulb, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions. (B) Following treatment the abdominal mass enlarged with extensive lymph node metastasis.
Mentions: The esophagogastroduodenoscopy revealed an ulcer in the duodenal bulb, measuring 1.2×1.5 cm in size, as well as mild chronic non-specific inflammation of the gastric antrum. An enhanced computed tomography scan of the abdomen (Fig. 1) showed mass lesions in the wall of the gastric antrum, duodenal bulb and descending segment, as well as enlarged lymph nodes in the abdominal and retroperitoneal regions (Fig. 1A). A biopsy of the ulcer mass was conducted via an endoscopy.

Bottom Line: To the best of our knowledge, this is the first study to report a case of duodenal PBL in an immunocompetent patient.Therefore, PBL represents a diagnostic and therapeutic challenge.PBL must be considered in the differential diagnosis of gastrointestinal tumors in daily practice, even in immunocompetent patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China ; Department of Hematology, West China Hospital, Sichuan University, Key Laboratory of Hematology of Sichuan Province, Chengdu, Sichuan 610041, P.R. China.

ABSTRACT
Plasmablastic lymphoma (PBL) is a rare and recently described entity of large B-cell lymphoma. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior without effective treatment. Recently, sporadic cases describing PBL in extraoral locations of HIV-negative patients have been reported; frequently in patients with underlying immunosuppressive states. To develop the understanding of PBL, the current study reports the unusual presentation of duodenal PBL and reviews the pathogenesis, immunohistochemical features, clinical and differential diagnoses, as well as the treatment of PBL as described in previous studies. The case of a 75-year-old female with duodenal PBL without definite immunosuppression is presented in the current report. The tumor was composed of large B-cell-like cells, and was positive for cluster of differentiation 138 and melanoma ubiquitous mutated-1, with ~80% of the tumor cells positive for Ki-67. The features of the tumor were as follows: Extraoral location, HIV-negative, immunoglobulin M λ-type M protein expression, light chain restriction (monoclonal) and Epstein-Barr virus-encoded small RNA-negative, which are considered to be unusual for PBL. These unusual features complicate the differentiation of PBL from other plasma cell diseases. To the best of our knowledge, this is the first study to report a case of duodenal PBL in an immunocompetent patient. To date, the standard treatment of PBL remains elusive, however, the most commonly administered chemotherapy treatments are CHOP [intravenous cyclophosphamide (750 mg/m(2), day 1), intravenous doxorubicin (50 mg/m(2), day 1), intravenous vincristine (1.4 mg/m(2), day 1) and prednisone (100 mg, days 1-50)]-like regimens. The patient was administered two cycles of CHOP chemotherapy for 56 days, however, ultimately succumbed as a result of disease progression. Therefore, PBL represents a diagnostic and therapeutic challenge. PBL must be considered in the differential diagnosis of gastrointestinal tumors in daily practice, even in immunocompetent patients. Furthermore, CHOP does not appear to be an optimal treatment regimen and more intensive regimens are required.

No MeSH data available.


Related in: MedlinePlus