Plasmablastic lymphoma involving the stomach in an HIV positive man
Dear Editor, A 50 year old human immunodeficiency virus (HIV) positive man, who was a smoker, exdrinker and drug user (marijuana and cocaine) was admitted to our hospital with fatigue, weakness, weight loss, impaired general condition and increased abdominal girth. He was diagnosed with a plasmablastic lymphoma (PBL) This type of lymphoma is considered to be a rare entity and is associated with states of immunosuppression. PBL represents approximately 2.6% of all lymphomas related to HIV and the most common location is the oral cavity. Other locations include the gastrointestinal tract, skin, central nervous system, sinuses, orbit, mediastinum, lungs, liver, testis and bone marrow. In this case PBL was detected in the stomach without involving the oral cavity. The primary diagnosis was made by cytology, but differentiation from other lymphomas was achieved by means of flow cytometry and immunostaining. The following tests carried out on ascitic fluid. Cytology. Cell count: 3370 cells/mm, with a monomorphic proliferation of round to oval shaped cells with plasmacytoid features: eccentric nucleus, abundant cytoplasm, central nucleolus and often a perinuclear halo (Figure 1) Flow cytometry: 75% leukocyte population: 0.7% lymphocyte population; 0.01% normal polyclonal B lymphocytes; 4.6% Tlymphocytes; 0.05% Natural Killer. 66% plasma cells monoclonal for kappa chains: CD 19 CD 20 CD 38 CD 138 CD45 CD10 CD 81 CD34 CD 56 1.85% monocytes; 4.9% population myeloid neutrophil granular; 25% Red blood cells (RBC) unlysed debris.
Cytopathology official journal of the British Society for Clinical Cytology