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Review
. 2019;98(6):546-550.
doi: 10.1159/000503586. Epub 2019 Oct 21.

An Endotracheal Plasmablastic Lymphoma

Eva M T Bots  1   2 , Johan Opperman  3 , Fatima Bassa  4 , Coenraad F N Koegelenberg  5
Affiliations
Review

An Endotracheal Plasmablastic Lymphoma

Eva M T Bots et al. Respiration. 2019.

Abstract

We describe an exceptionally rare case of a male patient with newly diagnosed advanced human immunodeficiency virus (HIV) infection, who presented with a plasmablastic lymphoma involving the right maxillary alveolar ridge with associated cervical lymphadenopathy. On a staging positron emission tomography computed tomography (PET-CT) scan, he was incidentally found to have an endotracheal tumour involving the anterolateral aspect of the mid-trachea. The tumour appeared to be well-vascularised at bronchoscopy and was confirmed as well-differentiated plasmablastic lymphoma. Plasmablastic lymphoma is a rare form of non-Hodgkin lymphoma and is associated with HIV. Tracheal involvement to the extent seen in our patient is exceptionally rare, and, to the best of our knowledge, has never been described.

Keywords: Endotracheal tumour; PET-CT scan; Plasmablastic lymphoma.

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Conflict of interest statement

The authors have nothing to declare.

Figures

Fig. 1
Fig. 1
a Biopsy of the maxillary lesion showed tumour cells exhibiting predominantly immunoblastic differentiation with focal plasmablastic differentiation. The tumour cells showed strong immunoreactivity with plasma cell-associated antigens CD138, MUMI, EMA, and CD38, variable positivity with the B cell markers CD45 and CD79a, and was completely negative for CD20, all compatible with a high-grade B cell non-Hodgkin lymphoma, particularly plasmablastic lymphoma. Cytoplasmic κ light chain restriction and EBV were present. a Maxillary tumour with oral mucosa with a submucosal tumour. ×200. b Submucosal infiltrate comprising sheets of immunoblastic cells exhibiting immunoreactivity with CD138. c Nuclear positivity with EBER-in situ hybridization. d Cytoplasmic κ light chain restriction. ×400.
Fig. 2
Fig. 2
a Staging PET-CT scan showed intense FDG uptake in the known right maxillary tumour, with associated destruction of the right maxillary bone but no evidence of intracranial extension. b It also showed a soft-tissue mass with mild FDG uptake involving the anterolateral aspect of the mid trachea. c At bronchoscopy, a well-vascularised tumour was seen with no other endobronchial abnormalities.
Fig. 3
Fig. 3
The histology of the endotracheal lesion also showed plasmacytic differentiation, with tumour cells exhibiting strong immunoreactivity with plasma cell-associated antigen CD138, MUMI, EMA, and CD38, but variable positivity with the B cell markers CD45 and CD79a, and completely negative for CD20. The endotracheal tumour cells differed cytomorphologically from the oral cavity tumour, showing a more mature plasmacytic differentiation. a Respiratory-type mucosa with a submucosal tumour. ×200. b Submucosal infiltrate comprising of sheets of cells with a plasmacytic differentiation, exhibiting immunoreactivity with CD138 (c) and positive for EBER-in situ hybridization (d;×400).
See this image and copyright information in PMC

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