Case Report
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World J Gastroenterol. Sep 7, 2014; 20(33): 11894-11903
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11894
Manifestations of gastrointestinal plasmablastic lymphoma: A case series with literature review
Lynette Luria, Johnny Nguyen, Jun Zhou, Michael Jaglal, Lubomir Sokol, Jane L Messina, Domenico Coppola, Ling Zhang
Lynette Luria, Johnny Nguyen, Department of Pathology, University of South Florida Morsani College of Medicine, Tampa, FL 33612, United States.
Jun Zhou, Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48202, United States
Jun Zhou, Ling Zhang, Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Michael Jaglal, Lubomir Sokol, Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Jane L Messina, Domenico Coppola, Department of Surgical Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Author contributions: Zhang L participated conceived the study and facilitated data collection; Zhang L also provided oversight of the study; Lucia L participated in drafting the manuscript, data collection, and statistical analysis; Nguyen J participated in drafting, revising, editing the manuscript as well as data collection; Zhou J helped in data collection and review of the manuscript; Messina JL, Coppola D and Sokol L provided support and review of the manuscript; Jaglal M contributed clinical information regarding the fourth case presented and reviewed the manuscript; all of the authors approved of the final version of the manuscript.
Correspondence to: Ling Zhang, MD, Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Rd., Tampa, FL 33612, United States. ling.zhang@moffitt.org
Telephone: +1-813-7452852 Fax: +1-813-7451708
Received: January 13, 2014
Revised: March 22, 2014
Accepted: May 23, 2014
Published online: September 7, 2014
Processing time: 237 Days and 10.4 Hours
Abstract

Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar case reports published in peer-reviewed journals. In our first case, a 40 year-old human immunodeficiency virus positive male presented with a hemorrhoid-like sensation, and was diagnosed with PBL via biopsy of a rectal mass. The second case involves a 65 year-old healthy male with bloody diarrhea who was found to have PBL in a resected sigmoid mass. The third patient was a 41 year-old male with a history of Crohn’s disease who presented with abdominal pain, diarrhea, and weight loss. A small intestinal mass (PBL) was removed. The fourth patient was a 65-year-old male who was found PBL after surgical resection of bowel for his florid Crohn’s disease. He later developed secondary acute myeloid leukemia. Clinical outcome was very poor in 3 out of 4 patients as reported in the literature. One patient survived chemotherapy followed by autologous transplant. The prototypical clinical presentation and variations of PBL can help create a more comprehensive differential diagnosis for GI tumors and establish an appropriate therapeutic guideline.

Keywords: Plasmablastic lymphoma; Undifferentiated carcinoma; Non-Hodgkin lymphoma; Diverse clinical manifestation and treatment

Core tip: Plasmablastic lymphoma rarely occurs as a primary lesion within the gastrointestinal tract. It frequently occurs in human immunodeficiency virus-positive patients, usually within the oral cavity. Its unique immunohistochemical profile may mislead unaware pathologists, and may potentially delay an accurate diagnosis and proper clinical treatment.