A rare case study of plasmablastic lymphoma involving the breast entitled “Plasmablastic lymphoma of the oral cavity with breast recurrence: a case report” was published in the BMC Research Notes by Zarka Samoon from the Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan, along with colleagues.
Plasmablastic lymphoma is an aggressive form of diffuse large B cell lymphoma, normally occurring in the oral cavity and associated with human immunodeficiency virus (HIV). The disease contributes to 2.6% of all HIV associated Non-Hodgkin’s lymphomas, a diverse group of blood cancers. Nevertheless, it can also occur in individuals who are HIV negative but immunocompromised, such as patients that were submitted to solid organ or bone marrow transplantation or with autoimmune disease.
Currently, no defined standard procedures are available for the treatment of plasmablastic lymphoma. Treatments more intensive than cyclophosphamide, doxorubicin, vincristine, and prednisone are not associated with a long survival. Of note, lymphomas of the breast are rare (among which Burkitt’s lymphomas are included) and very aggressive, affecting 0.14% of all female breast cancer patients. However, diffuse large B cell lymphoma contributes for at least 55% of all cases. This type of cancer is normally treated by combining chemotherapy with or without local irradiation but in the case of progression or relapse the response to therapy is considered poor.
In this study, the research team reported the second case of a 30 year old woman, who was HIV negative and immune competent, which showed a nodule in the floor of the mouth. The researchers found through morphological and immunohistochemistry analysis characteristics associated with plasmablastic lymphoma.
The patient was treated with chemotherapy followed by local radiation although later she presented disease relapse in the breast. After therapy with 4 rounds of cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP), and after radiation to the floor of her mouth, the tumor was in complete remission. After 2 months, the patient’s breast biopsy confirmed the diagnosis of plasmablastic lymphoma. The patient’s tumor progressed despite treatment with second and third line chemotherapy, respectively, DHAP (dexamethasone, cisplatin and cytarabine) and ICE (ifosfamide, carboplatin and etoposide). Until the point of the report, the patient had shown an overall survival of 15 months.
The authors highlighted that this clinical case was the second ever published study of plasmablastic lymphoma involving the breast.