Autopsy Case of Colonic Plasmablastic Lymphoma Exhibiting Unique Endoscopic Phenotypic Changes During Ulcerative Colitis Therapy

Plasmablastic lymphoma (PBL), a rare and aggressive CD20-negative B-cell lymphoma, has been increasingly recognized in individuals who are HIV-negative and who are also immunosuppressed. To our knowledge, we report the first autopsy case of a 74-year-old woman with ulcerative colitis (UC) who developed colonic PBL under immunosuppressive therapy. Serial colonoscopies demonstrated a morphologic transformation from serpiginous ulcers to elevated lesions. The patient ultimately died because of carcinomatous lymphangitis. Autopsy showed widespread metastases and numerous flat elevated lesions with lobulations throughout the colon. This case demonstrates a unique endoscopic phenotypic transition in colonic PBL, suggesting the importance of careful monitoring for timely diagnosis in immunosuppressed UC patients.