Abstract:
BACKGROUND : Plasmablastic lymphoma (PBL) is an aggressive neoplasm that commonly develops
in HIV-positive
patients, usually affecting the oral cavity. EBV is present in the majority
of cases, therefore, playing an important role in the pathogenesis of this neoplasm.
METHODS : PBL diagnosed from 2000 to 2020 were retrieved from the archives of the
Department of Oral Pathology and Oral Biology at the University of Pretoria, South
Africa. The patients’ clinical information including gender, age, tumour location and
HIV status was obtained from the original histopathology request forms. A morphological
description was assessed using H&E-stained
slides, with diagnoses confirmed
by immunohistochemistry, and EBV detection performed via in situ hybridisation.
RESULTS : During the 20 years period investigated, 113 PBL were found. Males outnumbered
females (M:F ratio of 3:1), with a median age of 41 years (range 8–62).
The
gingiva (50 cases or 44.2%) and the palate (23 cases or 20.4%) were the most affected
sites. All cases with available information were HIV positive. The tumours were composed
of a diffuse proliferation of immunoblasts or plasmablasts in all cases. A starry-sky
pattern, tissue necrosis, cellular pleomorphism and mitotic figures were common
microscopic findings. IHC for CD3 and CD20 were negative in all cases, while positivity
for CD38, CD138 and MUM1 was observed in 70.2%, 79.2% and 98.9%, respectively.
EBV was present in 100% of the cases.
CONCLUSION : PBL is a frequent diagnosis in South Africa, due to the country's HIV
burden, where it usually affects the oral cavity and is always associated with EBV
infection.
