摘要
Infection with human immunodeficiency virus (HIV) increases the risk of developing non-Hodgkin lymphoma. Plasmablastic lymphoma (PBL) is a rare variant of diffuse large cell lymphoma that often involves the oral cavity of HIV+patients. It is characterized by immunoblastic morphology and plasma cell phenotype. Cutan eous involvement in PBL appears to be rare. We report a 44-year-old man with A IDS and Kaposi sarcoma (KS) previously treated with doxorubicin who, following t reatment with highly active antiretroviral therapy, developed an erythematous in filtrated nodule on the right arm. Histology showed subcutaneous fat necrosis an d clusters of atypical large plasma cells (plasmablastic cells). Immunohistochem istry revealed λlight chain restriction. Epstein-Barr virus (EBV) mRNA was det ected by in situ hybridization within the plasmablastic cells. Polymerase chain reaction amplification with specific primers for human herpes-virus 8 (HHV-8) performed on the skin biopsy specimen detected a specific band. A complete scree ning (bone marrow biopsy, computed tomographic scan, radiological survey) disclo sed no abnormalities. The lesion resolved spontaneously after 3 months. Two year s later an infiltrated plaque developed on the abdominal wall. The clinical and histopathological features of this new lesion were similar to those observed 2 y ears previously. No evidence of extracutaneous involvement was detected. The les ion again resolved spontaneously after 25 days. PBL may be seen in patients with transplants or receiving chemotherapy, but is usually observed in patients with advanced AIDS. The observation of recurrent self-healing EBV-and HHV-8-asso ciated cutaneous monoclonal plasmablastic infiltrates, in a patient with AIDS an d KS, expands the clinical spectrum of AIDS-associated plasmablastic lymphoprol iferative disorders.
Infection with human immunodeficiency virus (HIV) increases the risk of developing non-Hodgkin lymphoma. Plasmablastic lymphoma (PBL) is a rare variant of diffuse large cell lymphoma that often involves the oral cavity of HIV+patients. It is characterized by immunoblastic morphology and plasma cell phenotype. Cutan eous involvement in PBL appears to be rare. We report a 44-year-old man with A IDS and Kaposi sarcoma (KS) previously treated with doxorubicin who, following t reatment with highly active antiretroviral therapy, developed an erythematous in filtrated nodule on the right arm. Histology showed subcutaneous fat necrosis an d clusters of atypical large plasma cells (plasmablastic cells). Immunohistochem istry revealed λlight chain restriction. Epstein-Barr virus (EBV) mRNA was det ected by in situ hybridization within the plasmablastic cells. Polymerase chain reaction amplification with specific primers for human herpes-virus 8 (HHV-8) performed on the skin biopsy specimen detected a specific band. A complete scree ning (bone marrow biopsy, computed tomographic scan, radiological survey) disclo sed no abnormalities. The lesion resolved spontaneously after 3 months. Two year s later an infiltrated plaque developed on the abdominal wall. The clinical and histopathological features of this new lesion were similar to those observed 2 y ears previously. No evidence of extracutaneous involvement was detected. The les ion again resolved spontaneously after 25 days. PBL may be seen in patients with transplants or receiving chemotherapy, but is usually observed in patients with advanced AIDS. The observation of recurrent self-healing EBV-and HHV-8-asso ciated cutaneous monoclonal plasmablastic infiltrates, in a patient with AIDS an d KS, expands the clinical spectrum of AIDS-associated plasmablastic lymphoprol iferative disorders.
