P5109 - Plasmablastic Lymphoma With Concurrent Kaposi Sarcoma in an Individual With HIV

Kaila Cohen, DO¹, Mrudula Bandaru, MD², Puja Sasankan, BS², Reid Schalet, MD², Ivan Berezowski, MD², Zeina Bani Hani, MBBS², Katherine Rangoussis, BS, MS², Maanvi Vij, BS², Omar K. Abu-Ghannam, BS², Al-Hafis Adegun, BA², Carol Gergis, MD, MS², Samuel A.. Schueler, MD², Marie L.. Borum, MD, MPH, FACG^2
1The George Washington University Hospital, Alexandria, VA; ²George Washington University School of Medicine and Health Sciences, Washington, DC

Introduction: Human Immunodeficiency Virus (HIV) is associated with an increased risk for malignancies including Kaposi Sarcoma (KS) and lymphomas. Plasmablastic Lymphoma (PBL), a rare, aggressive subtype of Diffuse Large B-Cell Lymphoma (DLBCL), primarily affects the oral cavity and gastrointestinal system of immunocompromised individuals. It represents ~2.6% of HIV-associated lymphomas. PBL often has a poor prognosis, with median survival of 11-15 months. Diagnosis and treatment of PBL is challenging due to overlapping symptoms with myeloma and other lymphomas, along with high rates of non-response and recurrence following standard DLBCL chemotherapy. We present a unique case of a male with newly diagnosed HIV and vague abdominal symptoms who was found to have plasmablastic lymphoma of the upper gastrointestinal tract and retroperitoneum, as well as concurrent cutaneous Kaposi Sarcoma.

Case Description/Methods: A 58-year-old male with venous insufficiency presented with progressively worsening dyspnea, reduced appetite, abdominal bloating, and constipation. CT angiography identified thickening of the esophagus, lesser curvature of the stomach and a large retroperitoneal mass with gastro-hepatic and porta-hepatic lymphadenopathy. Further investigation revealed that the patient was recently diagnosed with HIV/AIDS, chronic hepatitis B, and hepatitis C infections. The patient underwent an esophagogastroduodenoscopy with esophageal and gastric biopsies and retroperitoneal mass biopsy which confirmed the diagnosis of HIV-associated Plasmablastic Lymphoma. Immunohistochemical staining was strongly positive for CD138, MUM1, C-MYC, p53, and weakly positive for CD56, EMA, and CD43. Concurrently, he was found to have biopsy-confirmed Kaposi Sarcoma of the left lower extremity. The patient exhibited a rapid decline in clinical status and was unable to initiate treatment for his malignancies, ultimately succumbing to his condition.

Discussion: This case is a rare instance of an individual with retroperitoneal PBL and cutaneous KS with HIV, chronic HBV and HCV. There is currently only one reported case in the English literature of a patient similarly affected by HIV, PBL and KS. Our patient’s concurrent hepatitis B and hepatitis C may have contributed his rapid clinical deterioration. This unusual circumstance highlights the need to develop therapeutic regimens for PBL, including investigation of a role for proteasome inhibitors, recognizing that standard DLCBL chemotherapy is often not effective.


Disclosures:


Kaila Cohen, DO¹, Mrudula Bandaru, MD², Puja Sasankan, BS², Reid Schalet, MD², Ivan Berezowski, MD², Zeina Bani Hani, MBBS², Katherine Rangoussis, BS, MS², Maanvi Vij, BS², Omar K. Abu-Ghannam, BS², Al-Hafis Adegun, BA², Carol Gergis, MD, MS², Samuel A.. Schueler, MD², Marie L.. Borum, MD, MPH, FACG². P5109 - Plasmablastic Lymphoma With Concurrent Kaposi Sarcoma in an Individual With HIV, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.