Long-term survivor of human immunodeficiency virus-associated plasmablastic lymphoma
A 10-year-old male child presented to our center 7 years ago with a history of swelling of the right side of the face and intermittent fever of 2 months duration. On examination, he had pallor, palatal and upper alveolar mass, bilateral cervical adenopathy and hepatosplenomegaly. Baseline investigation showed Hb–7.3g/dL, TLC − 5.6 × 109/L, platelet count of 181 × 109/L. There was reversal of A: G ratio. Biopsy from oral mass was suggestive of PL. Bone marrow was not involved. ELISA for HIV-1 was reactive. Computed tomography, scan of the face, neck, chest, and abdomen showed a large oral cavity mass lesion with an extensive local spread and bony destruction, retroperitoneal adenopathy, multiple hypo-dense masses in both lobes of liver, with the hepatosplenomegaly. Serum protein electrophoresis showed no M band. Biopsy from oral mass showed sheets of small round cells with eccentric nuclei, vesicular nuclei and prominent nucleoli with plasmacytoid appearance. These cells were immunopositive for leucocyte common antigen (LCA), CD 79a, kappa light chain, epithelial membrane antigen (EMA) and CD138 and immunonegative for CD 20, CD3, MPO, and CD56 [Figures and ].\nFinal diagnosis of HIV associated high-grade lymphoma, plasmablastic type Stage IV was made.\nHe was treated with the high grade NHL protocol (MCP 842 protocol) that included – cyclophosphamide, vincristine, adriamycin, high-dose ara C, ifosfamide, etoposide along-with the central nervous system (CNS) prophylaxis.[] He was simultaneously started on HAART with lamivudine, stavudine and nevirapine. He completed the chemotherapy in 2003 and is in remission until last follow-up about 3 months ago. He is continuing HAART with same medicines and his latest CD4 cell count is 280 cells/mm3.