Abstract
Introduction: Plasmablastic Lymphoma (PL) is a rare non-Hodgkin’s lymphoma (NHL) commonly occurring as a solitary lesion in the oral cavity of HIV+ patients. The prognosis is poor, characterized by high rates of relapses and possible death. The aim of this report is to highlight the clinical presentation of an oral PL which lead to the diagnosis of HIV, that was unknown at the time of presentation.
Case details: A 33 year-old man was referred to an Oral Medicine Department in Oporto, Portugal, because of a 2 month-standing painless gingival overgrowth. The patient denied any symptoms or systemic disease. At clinical examination the patient, apparently healthy, presented a sessile gingival mass posterior to 3th upper left molar, with granulomatouslike appearance. The lesion was soft and haemorrhagic during palpation. No regional lymphadenopathies were detected. Orthopantomography didn´t show any significant osseous alterations. An incisional biopsy revealed a neoplastic cell population constituted by large cells with positivity to CD45, CD138, CD38 and MUN1, and also with high proliferation rate (90% of the tumours cells positive for Ki-67). Final pathology diagnosis corresponded to a PL. At this point of time, laboratory tests revealed positive serology for HIV infection. The patient was referred to the department of infectious diseases. The oral lesion disappeared after systemic chemotherapy and antiretroviral treatment. After 5 years of follow-up the patient is free of any recurrence and is continuing antiretroviral therapy.
Conclusion: This clinical case showed the importance of an accurate diagnosis for oral lesions which can sometime lead to diagnosis of systemic disease. Incisional biopsy, and serologic test are needed for diagnosis of PL associated to HIV infection. Relevance: In this case, the early detection of a PL made possible not only the treatment of the neoplastic disease but also the diagnosis and management of the HIV underlying infection.
Case details: A 33 year-old man was referred to an Oral Medicine Department in Oporto, Portugal, because of a 2 month-standing painless gingival overgrowth. The patient denied any symptoms or systemic disease. At clinical examination the patient, apparently healthy, presented a sessile gingival mass posterior to 3th upper left molar, with granulomatouslike appearance. The lesion was soft and haemorrhagic during palpation. No regional lymphadenopathies were detected. Orthopantomography didn´t show any significant osseous alterations. An incisional biopsy revealed a neoplastic cell population constituted by large cells with positivity to CD45, CD138, CD38 and MUN1, and also with high proliferation rate (90% of the tumours cells positive for Ki-67). Final pathology diagnosis corresponded to a PL. At this point of time, laboratory tests revealed positive serology for HIV infection. The patient was referred to the department of infectious diseases. The oral lesion disappeared after systemic chemotherapy and antiretroviral treatment. After 5 years of follow-up the patient is free of any recurrence and is continuing antiretroviral therapy.
Conclusion: This clinical case showed the importance of an accurate diagnosis for oral lesions which can sometime lead to diagnosis of systemic disease. Incisional biopsy, and serologic test are needed for diagnosis of PL associated to HIV infection. Relevance: In this case, the early detection of a PL made possible not only the treatment of the neoplastic disease but also the diagnosis and management of the HIV underlying infection.
| Original language | English |
|---|---|
| Pages (from-to) | 44 |
| Journal | Oral Diseases |
| Volume | 22 |
| Issue number | S2 |
| DOIs | |
| Publication status | Published - 14 Sept 2016 |
| Event | 13th Biennial Congress of the European Association of Oral Medicine - Torino, Italy Duration: 15 Sept 2016 → 17 Sept 2016 |
