Plasmablastic lymphoma pbl is an unusual entity of nonhodgkin lymphomas which. Diagnosis was offered as non hodgkins lymphoma, plasmablastic type. Case description a 35yearold chinese man presented with enlarged right axillary nodes without other systemic symptoms for 3 months. Cytokeratin positivity in anaplastic large cell lymphoma. All patients had either a core or open biopsy performed before the time of mastectomy. Cytokeratin 20 ck20 concentrated and prediluted monoclonal antibody 901062041919 rev. The term cytokeratin began to be used in the late 1970s, when the protein subunits of keratin intermediate filaments inside cells were first being identified and characterized. Pitfalls in immunohistochemistry in hematopathology. The expression of cytokeratin and neuron specific enolase in small cell carcinomas strongly suggests. Plasmablastic lymphoma pbl is a recently described subtype of diffuse large bcell lymphoma, which occurs almost exclusively in patients infected with human immunodeficiency virus hiv and involves the oral cavity and jaw. Rare cases of bcell lymphomas do not express conventional bcell markers cd20, cd79a, and pax5, and these types of lymphomas include alkpositive large bcell lymphoma, plasmablastic.
Plasmablastic lymphoma pbl is an aggressive bcell lymphoma that shows a plasma cell phenotype while lacking expression of bcell antigens. The data sheet recommendations and protocols are based on exclusive use of biocare products. Cxcr4 expression on circulating pancytokeratin positive. Neuronspecific enolase immunohistochemistry was positive in 60% of the cases. Cases of hhv8positive lymphoma with morphology and immunophenotype similar to those of primary effusion lymphoma but producing mass lesions in lymph nodes or in extranodal sites have also been. We report detailed clinical and pathologic features of four cases of anaplastic lymphoma kinasepositive diffuse large bcell lymphoma alkdlbcl, a rare entity with only 29 currently reported cases. Plasmablastic lymphoma pbl is an aggressive, highgrade bcell nonhodgkin lymphoma characterized by the proliferation of large bimmunoblast like neoplastic cells that display plasma cell differentiation associated with loss of conventional bcell antigens 1,2. Igd myelomaimmunoblastic lymphoma expressing cytokeratin article pdf available in british journal of cancer 535. Manifestations of gastrointestinal plasmablastic lymphoma. Plasmablastic lymphoma pbl is a rare malignancy derived from activated b. Using tissue microarray technology, we tested 1059 lymphoma and acute.
Cd79a, uchl1 cd45ro and cytokeratin ae1ae3, but positive for cd8. Cd3 positive gastric plasmablastic lymphoma in a hiv. Plasmablastic lymphoma pbl has been characterised by the world health organization as a new entity. To avoid this potential pitfall, a broadspectrum cytokeratin marker, such as ae, should be included in the test panel. Two pathologists independently assessed the axillary lymph nodes found. Plasmablastic lymphoma pbl is a rare and aggressive subtype of bcell lymphoma, which occurs typically in the oral cavity of human immunodeficiency virus hivpositive patients. Vulvar plasmablastic lymphoma in a hivpositive child. Diagnostic algorithm of common mature bcell lymphomas by. Ebvpositive plasmablastic lymphoma mimicking reactive. The cxc chemokine, cxcl12, and its receptor, cxcr4 promote metastases of a variety of solid tumors, including nonsmall cell lung cancer nsclc. Cytokeratinpositive, cd45negative primary centroblastic. Similarly, plasmablastic lymphoma is also a rare, aggressive, and typically fatal. This report describes an unusual case of pbl in a 3yearold hivinfected patient showing a cutaneous vulvar lesion with 9 months of evolution and prolapsed vulvovaginal mucosa.
Abstract we report a case of plasmablastic lymphoma presenting in. The expression of cxcr4 on tumor cells may represent a critical biomarker for their propensity to metastasize. The use of immunohistochemistry panels in cases that present in. These important observations using different technology platforms produce a new functional classification of.
Estrogen is read semiquantitatively as an average of the positive nuclei of the carcinoma. Intermediary filaments are involved in cell motility and cancer progression. While its pathogenesis is not yet fully understood it. Hematopathology september 2016 case study ebvpositive gastric plasmablastic lymphoma in an hivnegative adult eva m. It is known that cytokeratin ck is aberrantly expressed in a subset of plasma cell myelomas. The morphology of these positive cases included typical plasma cell, plasmablastic, and anaplastic morphology. For tumors, sometimes you cant tell the tumor type from its appearance under the microscope and special stains can be used, like cytokeratin, to decide what tumor type it may be. Lastly, cd8 staining results are almost always positive in a group of aggressive bcell lymphomas with plasmablastic features.
Plasmablastic lymphoma pbl is a rare highgrade large bcell lymphoma with. Basal cytokeratins and their relationship to the cellular. The lymph nodes were assessed with hematoxylin and. Although relatively rare, metastases to the uterine cervix from a primary colon cancer have been reported. In denmark the cut of point is 1%, and all below is considered negative. However, these histologic features may be seen in other disorders, such as plasmablastic pcm, bl, dlbcl with plasmacytoid differentiation, pel, and anaplastic lymphoma kinase alk positive dlbcl which make the correct diagnosis challenging. We determined the presence or absence of and clinical significance of cytokeratinpositive cells in the lymph nodes of patients who had had mastectomies for ductal carcinomainsitu. Among the different subtypes of dlbcl, plasmablastic lymphoma pbl is a variant that has attracted increased interest. Case report hiv seropositivity and neoplasms with plasma.
Plasmablastic lymphomas pbls were originally described exclu sively in human immunodeficiency virus hivpositive patients who presented with jaw or oral mucosa. Plasmablastic lymphoma of gingiva mimicking a reactive lesion. Request pdf cytokeratin expression in hematological neoplasms. In usa the patients is considered positive if but one nuclei is positive. A few of the cytokeratinpositive lymphomas also did not express cd45. Igd myelomaimmunoblastic lymphoma expressing cytokeratin. Plasmablastic lymphoma of the cervical lymph nodes in a. E shows expression of cytokeratin 8 in hodgkin cells. Plasmablastic myeloma versus plasmablastic lymphoma medcrave. Possible exceptions include synovial sarcoma, chordoma, ewings sarcoma, and epithelioid sarcoma. Cytokeratin 7 ck7 ovtl 1230 is a mouse monoclonal antibody that is intended for laboratory use in the qualitative identification of cytokeratin 7 ck7 protein by immunohistochemistry ihc in formalinfixed paraffinembedded ffpe human tissues. Plasmablastic lymphoma pbl is a unique lymphoma, first described by delecluse and associates as a rare variant of diffuse large bcell lymphoma dlbcl involving the oral cavity. Cytokeratin 818 expression indicates a poor prognosis in.
Interestingly, myeloid leukemia cell lines have been shown to express cytokeratin, and there are rare reports of cytokeratin expression in aml patients in the literature i. Cytologic features of plasmablastic lymphoma lin 2005. Expression of cytokeratin and neuronspecific enolase in. Plasmablastic lymphoma vs myeloma with plasmablastic. Hodgkins lymphomas arising in the oral cavity of hiv. A, b tissue microarray cores with cytokeratinexpressing mantle cell lymphoma and ce hodgkin lymphoma cases. The clinical significance of cytokeratinpositive cells in. Plasmablastic myeloma versus plasmablastic lymphoma. Both ae1ae3 and hmwck exhibited a dotlike staining pattern in a small subset of cells.
Cd45negative primary diffuse large bcell lymphoma of the. Plasmablastic lymphoma of the right testis sugimoto. Plasmablastic lymphoma presenting as a ureteral polypoid. Cytokeratins 8, 18, 19, and 20 have been associated with bladder 31. The aberrant expression of cytokeratin in plasma cell. Bcl6, pancytokeratin, cd79a, pax5, and cd15 were all negative on. Cd20 was negative, cd45 was weakly positive, and ki67 expression was. Anaplastic lymphoma kinasepositive diffuse large bcell. Cytokeratin expression in alkpositive dlbcl has already been described in sporadic patients. This is the first report of pbl of the testis in japan. Plasmablastic lymphoma of the cervical lymph nodes in a human. Pbl was originally described as a subtype of diffuse large cell lymphoma, presenting almost exclusively in jaw or oral mucosa of human immunode.
Case of plasmablastic lymphoma of the sigmoid colon and literature. Plasmablastic lymphoma pbl is distinct type of diffuse large b cell lymphoma dlbcl predominantly seen in hivpositive patients. We report a rare case of metastatic carcinoma originating from a cecal adenocarcinoma with an unusual cytokeratin 7. Desmin, for example, is not positive in small cell carcinoma, and cytokeratin is not positive in most lymphomas. Multiple myeloma mm is an indolent disorder of plasma cells that may similarly show plasmablastic morphology, thus posing a diagnostic challenge. Cytokeratin positivity helps corroborate a diagnosis of carcinoma and typically excludes the possibility of sarcoma, malignant lymphoma, or melanoma 1,2. Pathologists must be aware of this phenomenon to avoid diagnostic errors. Most authors define a positive staining result using a cutoff of 5% to 10% cell staining. Background plasmablastic lymphoma pbl is distinct type of diffuse large b cell lymphoma dlbcl predominantly seen in hivpositive patients.
We report a case of a 44yearold hivpositive patient with a solitary polypoid mass of the left ureteropelvic junction, causing unilateral hydronephrosis and. Fig 5 bone marrow aspirate showed 67 % plasma cells and few atypical cells. Because of its rarity, no standard management strategy has been established. All ck22positive cases, except for one mantle cell lymphoma, expressed the specific. Histopathological examination of a biopsy sample showed diffuse submucosal infiltration by large cells with a. Hhv8positive, ebvpositive hodgkin lymphomalike large b. The tumor cells were positive for cd8, cd38, epithelial membrane.
Plasmablastic lymphoma pbl is a relatively rare, but highly aggressive. Plasmablastic lymphoma pbl is classified by the world health organization as a type of mature bcell lymphoma that expresses plasma cell antigens cd38, cd8, mum1 but not common bcell antigens cd20, cd19, pax51,2. Ebvpositive gastric plasmablastic lymphoma in an hiv. A rare case of plasmablastic lymphoma with gastric involveme. Proteins are obligate heteropolymers with equimolar amounts of type i and type ii proteins that form functional filaments, such as ck818, ck514, ck110. The few cd45negative lbcl cases that have been reported in the literature had an extranodal presentation and were classified as a anaplastic lymphoma kinase alkpositive lbcl or as a plasmablastic lymphoma. This study was performed to evaluate the hypothesis that coexpression of pancytokeratin and cxcr4 may be a prognostic marker for.
Furthermore, several studies have been limited by the use of only 1 of the 2 stains or by the scope of tumors analyzed. Cytokeratin is a molecular feature of epithelial cells that line our body glands, skin, throat, etc. Cytokeratin fragment 211 cyfra 211 is a soluble fragment of cytokeratin 19 that can currently be measured either by a solidphase sandwich immunoradiometric assay or an electrochemiluminescent immunoassay. Hodgkin lymphoma, including dlbcl, burkitt lymphoma, and central nervous system cns lymphoma. Recent publications have classified breast cancers on the basis of expression of cytokeratin5 and 17 at the rna and protein levels, and demonstrated the importance of these markers in defining sporadic tumours with bad prognosis and an association with brca1related breast cancers. Plasmablastic lymphoma pbl is a rare form of nonhodgkins. Expression of cytokeratins 7 and 20 in ovarian neoplasia. In this study, we seeked to define the prognostic potential of cytokeratin and vimentin expression patterns in squamous cell carcinomas sccs of the oral cavity. Coexpression with cytokeratin was seen in ten cases 30%. Netter md school of medicine at quinnipiac university, hamden, ct.
In a variety of organs, the expression of distinct intermediary filaments are associated with patient prognosis. In this paper, we reported a case of cytokeratinpositive anaplastic large cell lymphoma in lymph node, which was misdiagnosed as a metastatic carcinoma. Cytologic features of plasmablastic lymphoma wiley online library. Ck7 expression in esophageal squamous cell carcinoma is an independent prognostic factor for poor overall survival neoplasma 2018. In 2006 a new systematic nomenclature for mammalian keratins was created, and the proteins previously called cytokeratins are simply called keratins human epithelial category. In humans, 20 different cytokeratin isotypes have been identified. The vast majority of uterine cervical malignancies are primary carcinomas, and secondary neoplasms that metastasize to the uterine cervix from a distant organ are uncommon. There was predominance of lambda expressing cells over kappa expressing cells. Plasmablastic myeloma is a rare and aggressive neoplasm with a poor prognosis.