Background: Plasmablastic lymphoma (PBL) is a recently recognized entity most often reported in the oral cavity, mainly in the setting of underlying human immunodeficiency viral infection whereby a role for Epstein-Ba...Background: Plasmablastic lymphoma (PBL) is a recently recognized entity most often reported in the oral cavity, mainly in the setting of underlying human immunodeficiency viral infection whereby a role for Epstein-Barr virus (EBV) and more recently human herpesvirus 8 (HHV8) has been described. Although EBV has been implicated in a variety of lymphoproliferativelesions, untilrecentlyHHV8has onlybeen associated with primary effusion lymphoma, multicentric Castleman’ s disease, and Kaposi’s sarcoma. We describe a case of PBL occurring in the setting of renal transplantation. Methods: We encountered a case of PBL occurring in the setting of renal transplantation. We characterized the tumor by routine immunohistochemistry and evaluated for the presence of immunoglobulin light chain restriction and EBV RNA by in situ hybridization. We assessed for the presence of HHV8 RNA by reverse transcriptase in situ hybridization. Results: The tumor showed a histomorphology compatible with a PBL. In addition, there was strong RNA expression in the neoplastic cells for EBER- 1, EBER-2, and HHV8. Conclusion: This case suggests a possible role of both viruses in the pathogenesis of PBL in sites other than the oral cavity and expands the spectrum of post- transplantation lymphoproliferative disease to include PBL.展开更多
Introduction:Drugs may be an important cause of atypical lymphocytic infiltration.Often times,these infiltrates are in the context of pseudolymphomata.We report a patient who developed lymphocytoma cutis temporally as...Introduction:Drugs may be an important cause of atypical lymphocytic infiltration.Often times,these infiltrates are in the context of pseudolymphomata.We report a patient who developed lymphocytoma cutis temporally associated with initiation of fluoxetine therapy that later went on to develop cutaneous marginal zone B-cell lymphoma.The response of peripheral blood lymphocytes to fluoxetine and other drugs was examined in an attempt to ascertain the potential role for drugs in the propagation of these infiltrates.Materials and Methods:Routine light microscopic analysis and phenotypic studies were performed on tissue obtained from a skin biopsy.Lymphocyte mitogenic studies were carried out using increasing concentrations of fluoxetine,bupropion,and two anticonvulsants.Results:An initial biopsy was consistent with lymphocytomacutis.The patient stopped fluoxetine associated with lesional regression.The lesions recurred despite being off fluoxetine;a repeat biopsy was compatible with marginal zone lymphoma.Lymphocyte proliferation assays revealed a suppressive effect on T-lymphocyte proliferation at physiologic concentrations.Other tested drugs did not have a similar suppressive effect.Conclusion:Fluoxetine may be associated with pseudolymphomata and marginal zone lymphoma.The inhibitory effects on T-lymphocyte function and more specifically T-suppressor function may lead to excessive antigen-driven B-cell proliferation.展开更多
文摘Background: Plasmablastic lymphoma (PBL) is a recently recognized entity most often reported in the oral cavity, mainly in the setting of underlying human immunodeficiency viral infection whereby a role for Epstein-Barr virus (EBV) and more recently human herpesvirus 8 (HHV8) has been described. Although EBV has been implicated in a variety of lymphoproliferativelesions, untilrecentlyHHV8has onlybeen associated with primary effusion lymphoma, multicentric Castleman’ s disease, and Kaposi’s sarcoma. We describe a case of PBL occurring in the setting of renal transplantation. Methods: We encountered a case of PBL occurring in the setting of renal transplantation. We characterized the tumor by routine immunohistochemistry and evaluated for the presence of immunoglobulin light chain restriction and EBV RNA by in situ hybridization. We assessed for the presence of HHV8 RNA by reverse transcriptase in situ hybridization. Results: The tumor showed a histomorphology compatible with a PBL. In addition, there was strong RNA expression in the neoplastic cells for EBER- 1, EBER-2, and HHV8. Conclusion: This case suggests a possible role of both viruses in the pathogenesis of PBL in sites other than the oral cavity and expands the spectrum of post- transplantation lymphoproliferative disease to include PBL.
文摘Introduction:Drugs may be an important cause of atypical lymphocytic infiltration.Often times,these infiltrates are in the context of pseudolymphomata.We report a patient who developed lymphocytoma cutis temporally associated with initiation of fluoxetine therapy that later went on to develop cutaneous marginal zone B-cell lymphoma.The response of peripheral blood lymphocytes to fluoxetine and other drugs was examined in an attempt to ascertain the potential role for drugs in the propagation of these infiltrates.Materials and Methods:Routine light microscopic analysis and phenotypic studies were performed on tissue obtained from a skin biopsy.Lymphocyte mitogenic studies were carried out using increasing concentrations of fluoxetine,bupropion,and two anticonvulsants.Results:An initial biopsy was consistent with lymphocytomacutis.The patient stopped fluoxetine associated with lesional regression.The lesions recurred despite being off fluoxetine;a repeat biopsy was compatible with marginal zone lymphoma.Lymphocyte proliferation assays revealed a suppressive effect on T-lymphocyte proliferation at physiologic concentrations.Other tested drugs did not have a similar suppressive effect.Conclusion:Fluoxetine may be associated with pseudolymphomata and marginal zone lymphoma.The inhibitory effects on T-lymphocyte function and more specifically T-suppressor function may lead to excessive antigen-driven B-cell proliferation.
