Primary leptomeningeal plasmablastic lymphoma

Lymphomas that develop in human immunodeficiency virus (HIV) infected patients are predominantly aggressive B-cells lymphomas. The most common HIV-associated lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma (that often involves the CNS), primary effusion lymphoma, and plasmablastic...

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Main Authors:	Mathews, Marlon S., Bota, Daniela A., Kim, Ronald C., Hasso, Anton N., Linskey, Mark E.
Format:	Online
Language:	English
Published:	Springer US 2011
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171045/

id	pubmed-3171045
recordtype	oai_dc
spelling	pubmed-31710452011-09-26 Primary leptomeningeal plasmablastic lymphoma Mathews, Marlon S. Bota, Daniela A. Kim, Ronald C. Hasso, Anton N. Linskey, Mark E. Case Report Lymphomas that develop in human immunodeficiency virus (HIV) infected patients are predominantly aggressive B-cells lymphomas. The most common HIV-associated lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma (that often involves the CNS), primary effusion lymphoma, and plasmablastic lymphoma (PBL). Of these, PBL is relatively uncommon and displays a distinct affinity for presentation in the oral cavity. In this manuscript we report a previously undescribed primary leptomeningeal form of PBL in a patient with acquired immunodeficiency syndrome. A 40-year-old HIV positive man presented with acute onset confusion, emesis, and altered mental status. Lumbar puncture showed numerous nucleated cells with atypical plasmocyte predominance. CSF flowcytometry showed kappa restriction with CD8 and CD38 positivity and negative lymphocyte markers, while the MRI showed diffuse leptomeningeal enhancement. As the extensive systemic work-up failed to reveal any disease outside the brain, an en bloc diagnostic brain and meningeal biopsy was performed. The biopsy specimen showed sheets of plasmacytoid cells with one or more large nuclei, prominent nuclear chromatin, scattered mitoses, and abundant cytoplasm, highly suggestive of plasmablastic lymphoma. HIV-associated malignancies have protean and often confusing presentations, which pose diagnostic difficulties posed to the practicing neurological-surgeons. Even in cases where an infectious cause is suspected for the meningeal enhancement, neoplastic involvement should be considered, and cytology and flow-cytometry should be routinely ordered on the CSF samples. Springer US 2011-02-27 2011-09 /pmc/articles/PMC3171045/ /pubmed/21359853 http://dx.doi.org/10.1007/s11060-011-0547-z Text en © The Author(s) 2011
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Mathews, Marlon S. Bota, Daniela A. Kim, Ronald C. Hasso, Anton N. Linskey, Mark E.
spellingShingle	Mathews, Marlon S. Bota, Daniela A. Kim, Ronald C. Hasso, Anton N. Linskey, Mark E. Primary leptomeningeal plasmablastic lymphoma
author_facet	Mathews, Marlon S. Bota, Daniela A. Kim, Ronald C. Hasso, Anton N. Linskey, Mark E.
author_sort	Mathews, Marlon S.
title	Primary leptomeningeal plasmablastic lymphoma
title_short	Primary leptomeningeal plasmablastic lymphoma
title_full	Primary leptomeningeal plasmablastic lymphoma
title_fullStr	Primary leptomeningeal plasmablastic lymphoma
title_full_unstemmed	Primary leptomeningeal plasmablastic lymphoma
title_sort	primary leptomeningeal plasmablastic lymphoma
description	Lymphomas that develop in human immunodeficiency virus (HIV) infected patients are predominantly aggressive B-cells lymphomas. The most common HIV-associated lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma (that often involves the CNS), primary effusion lymphoma, and plasmablastic lymphoma (PBL). Of these, PBL is relatively uncommon and displays a distinct affinity for presentation in the oral cavity. In this manuscript we report a previously undescribed primary leptomeningeal form of PBL in a patient with acquired immunodeficiency syndrome. A 40-year-old HIV positive man presented with acute onset confusion, emesis, and altered mental status. Lumbar puncture showed numerous nucleated cells with atypical plasmocyte predominance. CSF flowcytometry showed kappa restriction with CD8 and CD38 positivity and negative lymphocyte markers, while the MRI showed diffuse leptomeningeal enhancement. As the extensive systemic work-up failed to reveal any disease outside the brain, an en bloc diagnostic brain and meningeal biopsy was performed. The biopsy specimen showed sheets of plasmacytoid cells with one or more large nuclei, prominent nuclear chromatin, scattered mitoses, and abundant cytoplasm, highly suggestive of plasmablastic lymphoma. HIV-associated malignancies have protean and often confusing presentations, which pose diagnostic difficulties posed to the practicing neurological-surgeons. Even in cases where an infectious cause is suspected for the meningeal enhancement, neoplastic involvement should be considered, and cytology and flow-cytometry should be routinely ordered on the CSF samples.
publisher	Springer US
publishDate	2011
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171045/
_version_	1611475039394201600

Primary leptomeningeal plasmablastic lymphoma

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