Fragmented Chemotherapy of Plasmablastic Lymphoma in an Immunocompromised Patient

TL;DR

A rare and aggressive form of lymphoma in an immunocompromised patient was poorly managed due to incomplete chemotherapy, leading to a poor prognosis.

Contribution

This case highlights the challenges in treating plasmablastic lymphoma due to fragmented chemotherapy and late presentation.

Findings

The patient's PbL was associated with aggressive mandibular mass growth and facial bone involvement.

Fragmented chemotherapy and elopement during treatment led to a poor long-term prognosis.

Late presentation and incomplete treatment underscore the difficulty in managing PbL effectively.

Abstract

Plasmablastic lymphoma (PbL) is an uncommon subtype of diffuse large B-cell lymphoma, which is closely associated with human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) infections. Due to its rarity and characteristically aggressive nature, it has proven difficult to treat.

A rapidly growing mandibular mass can raise suspicion for malignancy. Our patient presented with a painful, enlarging mandibular mass in the absence of fever, night sweats, or fatigue. A review of imaging showed an 8.1 x 5.6 x 9.4 cm central destructive mass with soft tissue swelling, facial skin thickening, and involvement of facial bones. Biopsy was indicative of PbL. The patient was administered a chemotherapy regimen. However, the patient eloped during initial inpatient treatment. The patient returned to the hospital, but subsequent chemotherapy dispensing was irregular and incomplete. Due to the late presentation of the patient and fragmented treatment, the long-term prognosis is poor.

Figures