Why the study?
Plasmablastic lymphoma predominantly affects immunocompromised individuals and typically presents as oral or gastrointestinal masses, making its presentation as cardiac tamponade in an immunocompetent patient rare and difficult to suspect.
Plasmablastic lymphoma can rarely present as a malignant pericardial effusion causing cardiac tamponade in an immunocompetent, HIV-negative patient without an extranodal mass.
PBL literature remains dominated by case series in HIV; leaves open need for prospective registries to define management in immunocompetent patients.
Plasmablastic lymphoma (PBL) is a rare and aggressive subtype of diffuse large B-cell lymphoma, present predominantly in immunosuppressed individuals, particularly with human immunodeficiency virus (HIV) or Epstein-Barr virus (EBV) infection. Although the incidence of HIV-positive vs HIV-negative PBL is unknown, a literature review vastly associates it with immunocompromised status. Primarily seen in the male population in approximately 75% of reported cases, PBL has a well-established clinical presentation of one or two extra-nodal masses, generally in the oral cavity and gastrointestinal tract. We present a case of a 93-year-old female without any evidence of HIV infection or extra-nodal mass who presented with shortness of breath due to a large malignant pericardial effusion that evolved into a tamponade. Plasmablastic lymphoma is one of the few reported in HIV-negative individuals, and its unique presentation as a pericardial effusion without extranodal mass makes its suspicion less apparent. However, awareness of this entity, comprehensive immunohistochemistry, and most importantly, correlation with clinical presentation is the cornerstone to establishing a correct diagnosis.
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Kaul et al. (2024) studied this question.
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