Coexistence of plasmablastic lymphoma and adenocarcinoma in the stomach: a case report and literature review

TL;DR

A rare case of plasmablastic lymphoma in the stomach coexisting with adenocarcinoma is reported, highlighting unusual endoscopic features and treatment response.

Contribution

This case report presents the rare coexistence of gastric plasmablastic lymphoma and adenocarcinoma in an immunocompetent patient.

Findings

Gastric PBL presented with multiple polypoid lesions in an immunocompetent individual.

PBL coexisted with gastric differentiated adenocarcinoma in biopsy samples.

R-CHOP therapy led to partial tumor reduction, confirmed by endoscopic and histopathological follow-up.

Abstract

Plasmablastic lymphoma (PBL) is a rare B-cell lymphoma. Reports on primary gastric PBL are limited, and its endoscopic features remain poorly understood. We report a case of gastric PBL with multiple polypoid lesions in an immunocompetent individual. A 72-year-old man presented with upper abdominal discomfort. Esophagogastroduodenoscopy (EGD) revealed multiple raised lesions of variable sizes in the stomach, prompting a tumor biopsy. Based on histopathological findings, diffuse large B-cell lymphoma was suspected. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy was administered. After six cycles of R-CHOP therapy, EGD showed a partial reduction of the gastric tumor, and a biopsy was performed on the remaining tumor. Histopathology was re-examined, and immunohistochemical analysis revealed that the tumor cells were plasmablastic and strongly positive for both CD38 and CD138. The cells showed cytoplasmic immunoglobulin lambda light-chain restriction, indicating PBL. Furthermore, gastric differentiated adenocarcinoma was incidentally detected in some biopsy samples. Finally, a total gastrectomy was performed, and the postoperative course was uneventful. The patient is currently alive, 15 months after the initial diagnosis. This case reveals an endoscopic feature of gastric PBL and suggests the rare possibility that gastric PBL may coexist with adenocarcinoma.

The online version contains supplementary material available at 10.1007/s13691-025-00751-4.

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