{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T02:07:13Z","timestamp":1773194833517,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Plasmablastic lymphoma (PBL) is a rare and aggressive subtype of diffuse large B-cell lymphoma. Its transformation from multiple myeloma (MM) is an exceptionally rare event, with only nine cases reported in the literature. Differentiating PBL from plasmablastic myeloma (PBM) is a significant diagnostic challenge due to overlapping morphological and immunophenotypic features, yet it is critical for determining the appropriate treatment regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a woman in her 50s with a seven-year history of kappa-restricted MM who presented with a right leg mass. Biopsy confirmed a lambda-restricted plasmacytoma, indicating an extramedullary relapse. Two months after initiating therapy for myeloma relapse, she developed right inguinal lymphadenopathy. A lymph node biopsy revealed lambda-restricted plasmablasts positive for CD138, CD56, C-MYC, and Ki67 (100%), and negative for CD79a and EBER. In the absence of systemic MM-related end-organ damage and the presence of nodal disease, a diagnosis of PBL was favored over PBM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The patient was subsequently treated with DA-EPOCH chemotherapy (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin), leading to significant regression of disease on interim PET scan. This case represents the 10th reported transformation of MM to PBL and highlights the diagnostic dilemma posed by these entities. It underscores the importance of clinical context, the potential for clonal evolution (evidenced by a light-chain switch), and the efficacy of lymphoma-specific chemotherapy in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1778123","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:29:12Z","timestamp":1773120552000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: From multiple myeloma to plasmablastic lymphoma \u2013 a diagnostic dilemma in unraveling a rare transformation"],"prefix":"10.3389","volume":"16","author":[{"given":"Mohamad","family":"Shraim","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Abu Dis, Palestine"]},{"name":"Faculty of Applied Science, Palestine Ahliya University","place":["Bethlehem, Palestine"]},{"name":"Department of Pathology, Beit Jala Governmental Hospital","place":["Bethlehem, Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Salameh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Shamir Medical Center (Assaf Harofeh)","place":["Tzrifin, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akram","family":"Karama","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Abu Dis, Palestine"]},{"name":"Department of Hematology, Beit Jala Governmental Hospital","place":["Bethlehem, Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohaned Abu","family":"Lihya","sequence":"additional","affiliation":[{"name":"Department of Pathology, Istishari Arab Hospital","place":["Ramallah, Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-233340","article-title":"Pericardial relapse of multiple myeloma","volume":"13","author":"Jamison","year":"2020","journal-title":"BMJ Case Rep"},{"key":"B2","article-title":"Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles","volume":"18","author":"Vega","year":"2005","journal-title":"Mod Pathol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000126781.87158.e3","article-title":"Diffuse large B-cell lymphomas with plasmablastic differentiation represent a heterogeneous group of disease entities","volume":"28","author":"Colomo","year":"2004","journal-title":"Am J Surg Pathol"},{"key":"B4","article-title":"IgD plasmablastic myeloma: a case report with emphasis on the cytological 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Hematol Oncol"},{"key":"B8","doi-asserted-by":"crossref","DOI":"10.1038\/leu.2012.226","article-title":"Minor clone provides a reservoir for relapse in multiple myeloma","volume":"27","author":"Magrangeas","year":"2013","journal-title":"Leukemia"},{"key":"B9","doi-asserted-by":"crossref","DOI":"10.1016\/j.clml.2015.12.008","article-title":"Doxorubicin-based chemotherapy and radiation therapy produces favorable outcomes in limited-stage plasmablastic lymphoma: A single-institution review","volume":"16","author":"Pinnix","year":"2016","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.1182\/blood-2014-10-567479","article-title":"The biology and treatment of plasmablastic lymphoma","volume":"125","author":"Castillo","year":"2015","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"crossref","DOI":"10.1016\/j.bbmt.2015.03.008","article-title":"Autologous hematopoietic stem cell transplantation for plasmablastic lymphoma: the European Society for Blood and Marrow Transplantation experience","volume":"21","author":"Cattaneo","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw684","article-title":"Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group","volume":"28","author":"Tchernonog","year":"2017","journal-title":"Ann Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21250","article-title":"HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases","volume":"83","author":"Castillo","year":"2008","journal-title":"Am J Hematol"}],"container-title":["Frontiers in 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