Orbital plasmablastic lymphoma with remission following chemotherapy

J Radiol Case Rep. 2011;5(2):1-7. doi: 10.3941/jrcr.v5i2.617. Epub 2011 Feb 1.

Abstract

We report the case of a middle-aged HIV-positive man who presented with proptosis and retro-ocular pain. On CT and MR imaging, a retro-orbital enhancing mass was seen, and PET/CT revealed this lesion as well as a similarly characterized mass in the nasopharynx to be hypermetabolic. Biopsy and subsequent pathological characterization revealed this mass to be plasmablastic lymphoma (PBL), a rare form of non-Hodgkin's lymphoma associated with HIV-infection. PBL is a diffuse B-cell lymphoma with characteristic cell marker patterns. The most common site of this malignancy is within the oral cavity. This case constitutes an unusual orbital manifestation of plasmablastic lymphoma as well as an unusual case in its response to chemotherapy. This case illustrates the importance of functional imaging with PET/CT in the diagnosis, management, and follow-up of plasmablastic lymphoma.

Keywords: AIDS-related malignancy; Magnetic resonance imaging; Plasmablastic lymphoma; computed tomography; orbital tumor; positron emission tomography.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • HIV Infections / complications
  • Humans
  • Lymphoma / diagnostic imaging*
  • Lymphoma / drug therapy*
  • Lymphoma / pathology
  • Magnetic Resonance Imaging
  • Male
  • Multimodal Imaging
  • Orbital Neoplasms / diagnostic imaging*
  • Orbital Neoplasms / drug therapy*
  • Orbital Neoplasms / pathology
  • Polyethylene Glycols
  • Positron-Emission Tomography
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnostic imaging*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Prednisone / therapeutic use
  • Recombinant Proteins / therapeutic use
  • Remission Induction
  • Tomography, X-Ray Computed
  • Vincristine / therapeutic use

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Filgrastim
  • Prednisone

Supplementary concepts

  • EPOCH protocol
  • Orbital lymphoma