CD3+ CD56+ EBER1+ atypical extraosseous plasmacytoma of the nasal cavity

Int J Hematol. 2018 Sep;108(3):344-347. doi: 10.1007/s12185-018-2438-y. Epub 2018 Mar 23.

Abstract

We present a case of atypical extraosseous plasmacytoma (EP) with a plasmablastic morphology and CD3+ CD56+ Epstein-Barr virus-encoded RNA-1 (EBER1)+ phenotypes of the nasal cavity. A 51-year-old male attended a local hospital with a tumor located in his left nasal cavity that was histologically diagnosed as extranodal NK/T cell lymphoma, nasal type. We reviewed the specimens and re-biopsied the tumor, and confirmed that the tumor was positive for CD3, CD56, and EBER1; however, the tumor showed a plasmablastic morphology without necrosis and angiocentricity, and was positive for CD138, but negative for CD20 and PAX5. Given a plasmablastic morphology and EBER1 positivity, but a relatively low Ki67 index (30%), we diagnosed the case as atypical EP. The CHOP regimen was administered and complete remission achieved. This case indicated that EP should be considered as a differential diagnosis even when a tumor shows large cell morphology and is positive for CD3, CD56, and EBER1.

Keywords: CD3; CD56; Epstein–Barr virus; Nasal cavity; Plasmacytoma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • CD3 Complex* / analysis
  • CD56 Antigen* / analysis
  • Cyclophosphamide / administration & dosage
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • Herpesvirus 4, Human / genetics
  • Humans
  • Male
  • Middle Aged
  • Nasal Cavity / pathology*
  • Nose Neoplasms / diagnosis*
  • Nose Neoplasms / genetics*
  • Nose Neoplasms / pathology
  • Phenotype
  • Plasmacytoma / diagnosis*
  • Plasmacytoma / drug therapy
  • Plasmacytoma / genetics*
  • Plasmacytoma / pathology
  • Prednisolone / administration & dosage
  • RNA, Viral* / analysis
  • Remission Induction
  • Syndecan-1 / analysis
  • Vincristine / administration & dosage

Substances

  • Biomarkers, Tumor
  • CD3 Complex
  • CD56 Antigen
  • Epstein-Barr virus encoded RNA 1
  • NCAM1 protein, human
  • RNA, Viral
  • SDC1 protein, human
  • Syndecan-1
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone

Supplementary concepts

  • VAP-cyclo protocol