Plasmablastic Lymphoma of Head and Neck: Report of Two New Cases and Correlation with c-myc and IgVH Gene Mutation Status |
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Authors: | Anjum Hassan Friederike Kreisel Laura Gardner James S Lewis Jr Samir K El-Mofty |
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Institution: | (1) Department of Pathology and Immunology, Division of Anatomic Pathology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Ave, St. Louis, MO 63110, USA;(2) Department of Pathology, St. Louis University School of Medicine, St. Louis, MO 63110, USA |
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Abstract: | Plasmablastic lymphoma (PBL) is a rare acquired immunodeficiency syndrome-associated non-Hodgkin’s lymphoma (AIDS-NHL), with
predilection for the mucosa of oral cavity. It usually has a plasmablastic morphology, expressing plasma cell-associated antigens
with weak or absent expression of B-cell-associated markers. To further define the immunophenotypic and molecular genetics
of these tumors, we investigated two cases of plasmablastic lymphomas of the head and neck for c-myc gene rearrangement and
immunoglobulin heavy chain (IgVH) hypermutation status. For the first time we report a case of AIDS-related PBL that, by fluorescence in situ hybridization
(FISH), shows a c-myc gene rearrangement. Although current literature suggests that most cases of c-myc gene rearranged AIDS-NHL
are Burkitt’s lymphoma, our case has an immunophenotype characteristic for PBL. In this case, IgVH hypermutation analysis showed a somatic hypermutation, indicative of germinal center transit. The concurrent B-cell immunophenotype
of BCL-6−/CD138+/MUM-1+ also suggests a post-germinal center B-cell origin of this lymphoma. The immunophenotype of our second case (BCL-6−/CD138+/MUM-1+) also suggests a post-germinal center B-cell origin. However, IgVH hypermutation analysis was not possible in this case. |
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Keywords: | Plasmablastic lymphoma Acquired immunodeficiency syndrome-associated non-Hodgkin’ s lymphoma c-myc gene rearrangement Immunoglobulin variable heavy chain hypermutation status |
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