Extramedullary plasmacytoma: an unusual neoplasm in a HIV-positive patient

Author:

Joseph Anjana A1,Pulimood Susanne1,Manipadam Marie T2,Viswabandya Auro3,Sigamani Elanthenral2

Affiliation:

1. Department of Dermatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India

2. Department of Pathology, Christian Medical College Hospital, Vellore, Tamil Nadu, India

3. Department of Haematology, Christian Medical College Hospital, Vellore, Tamil Nadu, India

Abstract

There is a wide range of plasma cell abnormalities in people living with HIV (PLHIV). Extramedullary plasmacytomas are not common in HIV infection, unlike plasmablastic lymphomas. An HIV-positive 44-year-old man on antiretroviral therapy presented with a rapidly progressing swelling on the face. Imaging revealed underlying bone destruction. Histologically, there was a tumour composed of small to medium-sized plasmacytoid cells admixed with many mature plasma cells and plasmablasts. These were positive for CD138 and MUM 1. Extramedullary multiple myeloma was ruled out as CD56 and cyclin D-1 were negative. EBV was negative. As the tumour cells were mostly mature, plasmablastic lymphoma was also excluded. The presence of a monoclonal protein (1 g%), IgG kappa type, was detected. Neoplasia of plasma cells acquires special clinical characteristics in PLHIV. These patients are younger, with a greater tendency to develop solitary extramedullary plasmacytomas with atypical clinical evolution and greater aggressiveness of the neoplastic process. All of these features, along with a high proliferation index (MIB1 60%) was found in our patient. We report this case for its rarity, histopathological dilemma and its atypical features in HIV infection.

Publisher

SAGE Publications

Subject

Infectious Diseases,Pharmacology (medical),Public Health, Environmental and Occupational Health,Dermatology

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