Name
Plasmablastic lymphoma
Reportable
for cases diagnosed
2010 and later
Primary Site(s)
See Module 7
Most common sites of involvement: oral cavity mass, mucosal sites, sinonasal cavity, orbit, skin, bone, soft tissues and GI tract. For HIV negative patients-lymph nodes
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
(This code is effective for cases diagnosed 2010 and later. For cases diagnosed prior to 2010, see code 9684/3.)
PBL is uncommon. The highest incidence is in HIV-positive individuals.
Most patients present at Stages III/IV. The international prognostic index (IPI) is of intermediate to high risk.
EBV positivity is seen in the majority of patients.
PBL is uncommon. The highest incidence is in HIV-positive individuals.
Most patients present at Stages III/IV. The international prognostic index (IPI) is of intermediate to high risk.
EBV positivity is seen in the majority of patients.
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
None
Alternate Names
PBL
Definition
Plasmablastic lymphoma (PBL) is a very aggressive lymphoma with a diffuse proliferation of large neoplastic cells, most of which resemble B immunoblasts or plasmablasts, that have a CD20-negative plasmacytic phenotype.
Definitive Diagnostic Methods
Genetic testing
Histologic confirmation
Immunophenotyping
Genetics Data
Clonal IgH light chain rearrangement
Immunophenotyping
BCL2 and BCL6- (no expression/negative)
CD10+ (expression/positive)
CD20+/- (weakly positive/negative)
CD30+ (expression/positive)
CD38+ (expression/positive)
CD45+/- (weakly positive/negative)
CD56- (no expression/negative) in oral mucosal primary
CD79a+ (expression/positive)
CD138+ (expression/positive)
Cyclin D1- (no expression/negative)
Cytoplasmic immunoglobulins expressed, most frequently IgG and either kappa or lambda light chain
EBV+ (expression/positive)
EMA+ (expression/positive)
IRF4/MUM1
Ki67 proliferation index usually very high
PAX5+/- (weakly positive/negative)
PRDM1 (also called BLIMP1)
VS38c+ (expression/positive)
XBP1
Treatments
Chemotherapy
Hematologic Transplant and/or Endocrine Procedures
Radiation therapy
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Same Primaries
Corresponding ICD-9 Codes
200.7 Large cell lymphoma
Corresponding ICD-10 Codes
C83.3 Non-Hodgkin lymphoma large cell (diffuse)
Corresponding ICD-10-CM Codes (U.S. only)
C83.3 Diffuse large B-cell lymphoma (effective October 01, 2015)
Signs and Symptoms
Disseminated bone involvement
Drenching night sweats
Fatigue
Fever (for no known reason)
Painless swelling in the lymph nodes
Skin rash or itchy skin
Weight loss (for no known reason)
Diagnostic Exams
Blood chemistry studies
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Immunohistochemistry
Immunophenotyping
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
PET (positron emission tomography) scan
Progression and Transformation
None
Epidemiology and Mortality
Age: 50 years median age (mostly adults, rare in children)
Incidence: rare disease, most common lymphoma in HIV patients
Sex: male predominance
Survival: <1 year
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 321-322
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 321-322
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
National Cancer Institute
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq