Mediastinal syndrome from plasmablastic lymphoma in human immunodeficiency virus and human herpes virus 8 negative patient with polycythemia vera: a case reportReportar como inadecuado

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Journal of Medical Case Reports

, 11:75

First Online: 21 March 2017Received: 16 June 2016Accepted: 20 December 2016DOI: 10.1186-s13256-016-1183-1

Cite this article as: Cajozzo, M., Palumbo, V.D., Buscemi, S. et al. J Med Case Reports 2017 11: 75. doi:10.1186-s13256-016-1183-1


BackgroundPlasmoblastic lymphoma is a rare and aggressive subtype of diffuse large B cell lymphoma, which occurs usually in the jaw of immunocompromised subjects.

Case presentationWe describe the occurrence of plasmoblastic lymphoma in the mediastinum and chest wall skin of an human immunodeficiency virus-negative 63-year-old Caucasian man who had had polycytemia vera 7 years before. At admission, the patient showed a superior vena cava syndrome, with persistent dyspnoea, cough, and distension of the jugular veins. Imaging findings showed a 9.7 × 8 × 5.7 cm mediastinal mass. A chest wall neoformation biopsy and ultrasound-guided fine-needle aspiration biopsy of the mediastinal mass allowed diagnosis of plasmoblastic lymphoma and establishment of an immediate chemotherapeutic regimen, with rapid remission of compression symptoms.

ConclusionsPlasmoblastic lymphoma is a very uncommon, difficult to diagnose, and aggressive disease. The presented case represents the first rare mediastinal plasmoblastic lymphoma in a human immunodeficiency virus-human herpesvirus-8-negative patient. Pathologists should be aware that this tumor does appear in sites other than the oral cavity. Fine-needle aspiration biopsy is a low-cost, repeatable, easy-to-perform technique, with a high diagnostic accuracy and with very low complication and mortality rates. Fine-needle aspiration biopsy could represent the right alternative to surgery in those patients affected by plasmoblastic lymphoma, being rapid and minimally invasive. It allowed establishment of prompt medical treatment with subsequent considerable reduction of the neoplastic tissue and resolution of the mediastinal syndrome.

KeywordsCase report Fine-needle aspiration biopsy Hematology Rare clinical case Thoracic surgery AbbreviationsCHOPcyclophosphamide, doxorubicin, vincristine, prednisone

CODOX-M-IVACcyclophosphamide, vincristine, doxorubicin, high-dose methotrexate-ifosfamide, etoposide, high-dose cytarabine

CTcomputed tomography

DLBCLdiffuse large B cell lymphoma

EBVEpstein–Barr virus

FNABfine-needle aspiration biopsy

HAARThighly active anti-retroviral therapy

HHV8human herpesvirus-8

HIVhuman immunodeficiency virus

NCCNNational Comprehensive Cancer Network

PBLplasmoblastic lymphoma


WHOWorld Health Organization

Autor: Massimo Cajozzo - Vincenzo Davide Palumbo - Salvatore Buscemi - Giuseppe Damiano - Ada Maria Florena - Daniela Cabibi - Fr


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