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Plasmablastic lymphoma versus plasmablastic myeloma: an ongoing diagnostic dilemma
  1. Janice S Ahn1,
  2. Ryan Okal1,
  3. Jeffrey A Vos1,
  4. Matthew Smolkin1,
  5. Abraham S Kanate2,
  6. Flavia G Rosado1
  1. 1Department of Pathology, West Virginia University, Morgantown, West Virginia, USA
  2. 2Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
  1. Correspondence to Dr Flavia G Rosado, Department of Pathology, West Virginia University, 1 Medical Center Dr, Room 2146F/HSC North, Morgantown, WV 26506, USA; fgrosado{at}hsc.wvu.edu

Abstract

Aims To determine the utility of clinical, morphological and phenotypical features in the differential diagnosis of plasmablastic lymphoma and myeloma with plasmablastic features.

Methods All plasmablastic neoplasms identified from a 15-year retrospective search were reviewed and classified into ‘lymphoma’, ‘myeloma’ or ‘indeterminate’. The classification was then compared with the previously established clinical diagnosis. Lessons learned from this review were used to design a diagnostic algorithm for pathologists to use in the absence of known clinical history.

Results The classification was possible in 10 of 11 cases, 8 lymphomas and 2 myelomas (n=2). No distinctive morphological or phenotypical features were identified. The most useful histopathological parameter was a positive Epstein-Barr virus in situ hybridisation. Presence of associated lymphadenopathy and/or oral mass in the absence of complete myeloma-defining signs was used to favour a diagnosis of lymphoma in 4 of 8 cases.

Conclusions The distinction between plasmablastic lymphoma from plasmablastic myeloma warrants detailed knowledge of clinical, radiological and laboratorial findings. New studies identifying distinctive phenotypical or genetic features are needed to improve the histopathological differentiation of plasmablastic neoplasms.

  • LYMPHOMA
  • MYELOMA
  • HISTOPATHOLOGY
  • DIAGNOSIS
  • IMMUNOHISTOCHEMISTRY

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Footnotes

  • Handling editor Mary Frances McMullin

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript.

  • Competing interests None declared.

  • Ethics approval West Virginia University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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