CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
This article is part of the Research TopicCase-based Advances in the Understanding of Rare and Unusual Hematologic Malignancies 2025-2026View all 20 articles
Case Report: From Multiple Myeloma to Plasmablastic Lymphoma – A Diagnostic Dilemma in Unraveling a Rare Transformation
Provisionally accepted
- 1Beit Jala Governmental Hospital, Bethlehem, Palestine
- 2Palestine Ahliya University, Bethlehem, Palestine
- 3Shamir Medical Center Assaf Harofeh, Tzrifin, Israel
- 4Al Quds University Faculty of Medicine, Jerusalem, Palestine
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: 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. Case Presentation: 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. Conclusion: 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.
Keywords: case report, Clonal Evolution, DA-EPOCH chemotherapy, Diagnostic challenge, EBV-negative PBL, Extramedullary relapse, multiple myeloma transformation, Plasmablastic lymphoma
Received: 30 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Shraim, Salameh and Karama. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mohamad Shraim
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.