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Spontaneous Regression Of Plasmablastic Lymphoma In An Immunocompetent Patient: Case Report And Review Of The Literature

Lee, K. T. 2022Lymphoma

Lee, K. T., Misron, N. A., Abdul Aziz, N., Wong, C. H., & Liew, H. K. (2022). Spontaneous Regression of Plasmablastic Lymphoma in an Immunocompetent Patient: Case Report and Review of the Literature. Case reports in hematology, 2022, 1142049. https://doi.org/10.1155/2022/1142049

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Abstract

Plasmablastic lymphoma (PBL) is a rare and highly aggressive type of lymphoma, which is commonly associated with human immunodeficiency virus (HIV) infection. Spontaneous regression of aggressive lymphomas is rare as they typically require administration of chemotherapy and radiotherapy for treatment. Here, we describe a case of a spontaneous regression of PBL after nasal biopsy and computed tomography (CT) guided biopsy of paravertebral mass in an immunocompetent patient. We postulate that the patient's immune system may be activated as a result of the stress and physical trauma brought on by nasal and paravertebral mass biopsy. Our case highlights the rare phenomenon of spontaneous regression of lymphoma which needs to be further studied on to establish its underlying pathophysiology.

Case Details

Disease Location

Sinus

Personal Characteristics

61-year-old man

Clinical Characteristics

Three weeks history of intermittent epistaxis, nasal block, and loss of weight. Rigid nasal endoscopy revealed a smooth surface mass covering the entire left nasal cavity. CT revealed a mass over the left frontal and ethmoid sinuses which occupied almost the entire left nasal cavity. Incidentally, there was a well-defined heterogeneously enhancing mass at the left paravertebral region (7.1 × 7.8 × 7.8 cm) with extension into left t7/8 neural foramina. Nasopharyngeal mass biopsy was performed and the diagnosis of plasmablastic lymphoma (pbl) was made. CT-guided biopsy of the paravertebral mass, and his histopathological examination results came back later which revealed ancient schwannoma.

Remission Characteristics

Spontaneous regression of his pbl was confirmed by a repeat rigid nasal endoscopy, which showed good patency of both nasal cavities, and a repeat CT scan of the paranasal sinuses, which revealed spontaneous regression of his left nasal mass

Treatment & Mechanisms

Proposed Remission Mechanisms

The patient’s immune system may be activated as a result of the stress and physical trauma brought on by nasal and paravertebral mass biopsy.

Clinical Treatment

Biopsy

Non-Clinical Treatment

None reported