Did you mean: plasmablasts lymphoma
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International Journal of Laboratory... Sep 2022Plasmablastic lymphoma (PBL) is a highly aggressive B cell non-Hodgkin lymphoma frequently associated with immunosuppression, particularly human immunodeficiency virus... (Review)
Review
Plasmablastic lymphoma (PBL) is a highly aggressive B cell non-Hodgkin lymphoma frequently associated with immunosuppression, particularly human immunodeficiency virus (HIV) infection. Although PBL is rare globally, South Africa has a high burden of HIV infection leading to a higher incidence of PBL in the region. Laboratory features in PBL may overlap with plasmablastic myeloma and other large B cell lymphomas with plasmablastic or immunoblastic morphology leading to diagnostic dilemmas. There are, however, pertinent distinguishing laboratory features in PBL such as a plasma cell immunophenotype with MYC overexpression, expression of Epstein-Barr virus-encoded small RNAs and lack of anaplastic lymphoma kinase (ALK) expression. This review aims to provide a summary of current knowledge in PBL, focusing on the epidemiology, pathophysiology, laboratory diagnosis and clinical management.
Topics: Epstein-Barr Virus Infections; HIV Infections; Herpesvirus 4, Human; Humans; Immunophenotyping; Plasmablastic Lymphoma
PubMed: 36074710
DOI: 10.1111/ijlh.13863 -
Blood Feb 2022HIV infection increases cancer risk and is linked to cancers associated to infectious agents classified as carcinogenic to humans by the International Agency for... (Review)
Review
HIV infection increases cancer risk and is linked to cancers associated to infectious agents classified as carcinogenic to humans by the International Agency for Research on Cancer. Lymphomas represent one of the most frequent malignancies among individuals infected by HIV. Diffuse large B-cell lymphoma remains a leading cancer after the introduction of combined antiretroviral therapy (cART). The incidence of other lymphomas including Burkitt lymphoma, primary effusion lymphomas, and plasmablastic lymphoma of the oral cavity remain stable, whereas the incidence of Hodgkin lymphoma and Kaposi sarcoma-associated herpesvirus (KSHV)-associated multicentric Castleman disease has increased. The heterogeneity of lymphomas in individuals infected by HIV likely depends on the complexity of involved pathogenetic mechanisms (ie, HIV-induced immunosuppression, genetic abnormalities, cytokine dysregulation, and coinfection with the gammaherpesviruses Epstein-Barr virus and KSHV) and the dysregulation of the immune responses controlling these viruses. In the modern cART era, standard treatments for HIV-associated lymphoma including stem cell transplantation in relapsed/refractory disease mirror that of the general population. The combination of cART and antineoplastic treatments has resulted in remarkable prolongation of long-term survival. However, oncolytic and immunotherapic strategies and therapies targeting specific viral oncogenes will need to be developed.
Topics: HIV; HIV Infections; Hematologic Neoplasms; Humans; Lymphoma, AIDS-Related
PubMed: 34469512
DOI: 10.1182/blood.2020005469 -
American Journal of Hematology Jul 2022Epstein Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is an entity included in the WHO classification of lymphoid... (Review)
Review
DISEASE OVERVIEW
Epstein Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is an entity included in the WHO classification of lymphoid neoplasms since 2016. EBV+ DLBCL, NOS, is an aggressive B-cell lymphoma associated with EBV infection, and a poor prognosis with standard chemotherapeutic approaches.
DIAGNOSIS
The diagnosis is made through a careful pathological evaluation. Detection of EBV-encoded RNA (EBER) is considered standard for diagnosis; however, a clear cutoff for percentage of positive cells has not been defined. The differential diagnosis includes plasmablastic lymphoma (PBL), DLBCL associated with chronic inflammation, primary effusion lymphoma (PEL), among others.
RISK-STRATIFICATION
The International Prognostic Index (IPI) and the Oyama score can be used for risk-stratification. The Oyama score includes age >70 years and presence of B symptoms. The expression of CD30 and PD-1/PD-L1 are emerging as potential adverse but targetable biomarkers.
MANAGEMENT
Patients with EBV+ DLBCL, NOS, should be staged and managed following similar guidelines than patients with EBV-negative DLBCL. EBV+ DLBCL, NOS, however, might have a worse prognosis than EBV-negative DLBCL in the era of chemoimmunotherapy. Therefore, the inclusion of patients in clinical trials when available is recommended. There is an opportunity to study and develop targeted therapy in the management of patients with EBV+ DLBCL, NOS.
Topics: Aged; Diagnosis, Differential; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Lymphoma, Large B-Cell, Diffuse; Prognosis
PubMed: 35472248
DOI: 10.1002/ajh.26579 -
Virchows Archiv : An International... Sep 2023Emerging entities and molecular subgroups in large B-cell lymphomas (LBCLs) were discussed during the 2022 European Association for Haematopathology/Society for... (Review)
Review
Emerging entities: high-grade/large B-cell lymphoma with 11q aberration, large B-cell lymphoma with IRF4 rearrangement, and new molecular subgroups in large B-cell lymphomas. A report of the 2022 EA4HP/SH lymphoma workshop.
Emerging entities and molecular subgroups in large B-cell lymphomas (LBCLs) were discussed during the 2022 European Association for Haematopathology/Society for Hematopathology workshop in Florence, Italy. This session focused on newly recognized diseases and their diagnostic challenges. High-grade/large B-cell lymphoma with 11q aberration (HG/LBCL-11q) is defined by chromosome 11q-gains and telomeric loss. FISH analysis is recommended for the diagnosis. HG/LBCL-11q can occur in the setting of immunodeficiency, including ataxia-telangiectasia, and predominates in children. The morphological spectrum of these cases is broader than previously thought with often Burkitt-like morphology and coarse apoptotic bodies. It has a Burkitt-like immunophenotype (CD10+, BCL6+, BCL2-) but MYC expression is weak or negative, lacks MYC rearrangement, and is in contrast to Burkitt lymphoma 50% of the cases express LMO2. LBCL with IRF4 rearrangement (LBCL-IRF4) occurs mainly in the pediatric population but also in adults. LBCL-IRF4 has an excellent prognosis, with distinguishing molecular findings. IRF4 rearrangements, although characteristic of this entity, are not specific and can be found in association with other chromosomal translocations in other large B-cell lymphomas. Other molecular subgroups discussed included primary bone diffuse large B-cell lymphoma (PB-DLBCL), which has distinctive clinical presentation and molecular findings, and B-acute lymphoblastic leukemia (B-ALL) with IGH::MYC translocation recently segregated from Burkitt lymphoma with TdT expression. This latter disorder has molecular features of precursor B-cells, often tetrasomy 1q and recurrent NRAS and KRAS mutations. In this report, novel findings, recommendations for diagnosis, open questions, and diagnostic challenges raised by the cases submitted to the workshop will be discussed.
Topics: Adult; Humans; Child; Burkitt Lymphoma; Lymphoma, Large B-Cell, Diffuse; Chromosome Aberrations; Translocation, Genetic; Mutation
PubMed: 37555980
DOI: 10.1007/s00428-023-03590-x -
Haematologica Oct 2021
Topics: Humans; Lymphoma, Large B-Cell, Diffuse; Plasma Cells; Plasmablastic Lymphoma
PubMed: 33951892
DOI: 10.3324/haematol.2021.278841 -
Immunity Aug 2019Class-switch recombination (CSR) is a DNA recombination process that replaces the immunoglobulin (Ig) constant region for the isotype that can best protect against the...
Class-switch recombination (CSR) is a DNA recombination process that replaces the immunoglobulin (Ig) constant region for the isotype that can best protect against the pathogen. Dysregulation of CSR can cause self-reactive BCRs and B cell lymphomas; understanding the timing and location of CSR is therefore important. Although CSR commences upon T cell priming, it is generally considered a hallmark of germinal centers (GCs). Here, we have used multiple approaches to show that CSR is triggered prior to differentiation into GC B cells or plasmablasts and is greatly diminished in GCs. Despite finding a small percentage of GC B cells expressing germline transcripts, phylogenetic trees of GC BCRs from secondary lymphoid organs revealed that the vast majority of CSR events occurred prior to the onset of somatic hypermutation. As such, we have demonstrated the existence of IgM-dominated GCs, which are unlikely to occur under the assumption of ongoing switching.
Topics: Animals; B-Lymphocytes; Cell Differentiation; Cells, Cultured; Germinal Center; Humans; Immunoglobulin Class Switching; Mice; Mice, Inbred C57BL; Phylogeny; Plasma Cells; Plasmablastic Lymphoma; Receptors, Antigen, B-Cell; T-Lymphocytes, Helper-Inducer
PubMed: 31375460
DOI: 10.1016/j.immuni.2019.07.001 -
The FEBS Journal Dec 2022Epstein-Barr virus (EBV; human herpesvirus 4; HHV-4) and Kaposi sarcoma-associated herpesvirus (KSHV; human herpesvirus 8; HHV-8) are human gammaherpesviruses that have... (Review)
Review
Epstein-Barr virus (EBV; human herpesvirus 4; HHV-4) and Kaposi sarcoma-associated herpesvirus (KSHV; human herpesvirus 8; HHV-8) are human gammaherpesviruses that have oncogenic properties. EBV is a lymphocryptovirus, whereas HHV-8/KSHV is a rhadinovirus. As lymphotropic viruses, EBV and KSHV are associated with several lymphoproliferative diseases or plasmacytic/plasmablastic neoplasms. Interestingly, these viruses can also infect epithelial cells causing carcinomas and, in the case of KSHV, endothelial cells, causing sarcoma. EBV is associated with Burkitt lymphoma, classic Hodgkin lymphoma, nasopharyngeal carcinoma, plasmablastic lymphoma, lymphomatoid granulomatosis, leiomyosarcoma, and subsets of diffuse large B-cell lymphoma, post-transplant lymphoproliferative disorder, and gastric carcinoma. KSHV is implicated in Kaposi sarcoma, primary effusion lymphoma, multicentric Castleman disease, and KSHV-positive diffuse large B-cell lymphoma. Pathogenesis by these two herpesviruses is intrinsically linked to viral proteins expressed during the lytic and latent lifecycles. This comprehensive review intends to provide an overview of the EBV and KSHV viral cycles, viral proteins that contribute to oncogenesis, and the current understanding of the pathogenesis and clinicopathology of their related neoplastic entities.
Topics: Humans; Epstein-Barr Virus Infections; Endothelial Cells; Herpesvirus 4, Human; Sarcoma, Kaposi; Herpesvirus 8, Human; Lymphoma, Large B-Cell, Diffuse; Viral Proteins
PubMed: 34536980
DOI: 10.1111/febs.16206 -
Archives of Pathology & Laboratory... Apr 2022Plasmablastic morphology can be seen in several uncommon lymphoproliferative neoplasms. Sometimes it is difficult to distinguish these neoplasms from each other.
CONTEXT.—
Plasmablastic morphology can be seen in several uncommon lymphoproliferative neoplasms. Sometimes it is difficult to distinguish these neoplasms from each other.
OBJECTIVE.—
To review the current understanding of major lymphoproliferative neoplasms with plasmablastic morphology; summarize the clinical, morphologic, immunophenotypic, cytogenetic, and molecular characteristics of each disease entity; and highlight a practical approach for differential diagnosis.
DATA SOURCES.—
Peer-reviewed medical literature and the authors' personal experience.
CONCLUSIONS.—
Plasmablastic lymphoma; plasmablastic myeloma; primary effusion lymphoma; human herpesvirus 8-positive diffuse large B-cell lymphoma, not otherwise specified; and anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma are major lymphoproliferative neoplasms with plasmablastic morphology. These neoplasms share many common morphologic and immunophenotypic characteristics. Definitive diagnosis requires a thorough understanding of disease phenotype and diagnostic criteria of each category. Recognition of expression pattern of Epstein-Barr virus-encoded small RNA, human herpesvirus 8, and ALK in these neoplasms is critical for diagnosis in cases with typical presentation. Additional ancillary studies and clinical findings may help in difficult cases.
Topics: Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Lymphoma, Large B-Cell, Diffuse; Plasma Cells; Receptor Protein-Tyrosine Kinases
PubMed: 34559873
DOI: 10.5858/arpa.2021-0117-RA -
Journal of Clinical and Experimental... 2023Outcomes of patients with histologic transformation (HT) of follicular lymphoma (FL) have been believed to be poor. The most common histologic subtype of transformation... (Review)
Review
Outcomes of patients with histologic transformation (HT) of follicular lymphoma (FL) have been believed to be poor. The most common histologic subtype of transformation from FL is diffuse large B-cell lymphoma (DLBCL), which accounts for 90% of the cases, and the remaining 10% of the cases include classic Hodgkin lymphoma, high-grade B-cell lymphoma, plasmablastic lymphoma, B-acute lymphoblastic leukemia/lymphoma, histiocytic/dendritic cell sarcoma, and anaplastic large cell lymphoma-like lymphoma. Because the histologic criteria for the diagnosis of DLBCL transformed from FL are unclear, convenient histopathological criteria for HT are required. One of the proposed criteria of HT from our institute is the presence of diffuse architecture with a proportion of large lymphoma cells of ≥20%, and for challenging cases, Ki-67 index ≥50% is used as a reference. Patients with HT to non-DLBCL have poorer outcomes than those with HT to DLBCL; thus, rapid and accurate histologic diagnosis is desired. In this review, we discussed the recent literatures describing the histopathologic variety and proposal of definition of HT.
Topics: Humans; Lymphoma, Follicular; Pathologists; Lymphoma, Large B-Cell, Diffuse; Plasmablastic Lymphoma; Lymphoma, Large-Cell, Anaplastic; Cell Transformation, Neoplastic
PubMed: 36990772
DOI: 10.3960/jslrt.22046