Occurrence of plasmablastic lymphoma in the oral cavity of an atomic blast survivor

Plasmablastic lymphoma (PBL) is an uncommon but aggressive subtype of diffuse, large, B-cell lymphoma characterized by plasmablastic differentiation. It is a rare tumor and is known to occur most often in individuals with an immunocompromised state due to human immunodeficiency virus (HIV) or Epstein-Barr virus (EBV). Here we report a case of PBL with no evidence of HIV or EBV infection in a 76-year-old survivor of the Nagasaki atomic bombings who was exposed at the age of 3 years. The patient presented to our hospital with a complaint of an oral mass. He was diagnosed with PBL and treated with EPOCH chemotherapy (etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin). No recurrence was observed after 3 years. The possibility of an effect of atomic bomb radiation exposure on the development of PBL cannot be ruled out in this case. However, epidemiological studies cannot prove this hypothesis because only a limited number of individuals are survivors of atomic bombings. To the best of our knowledge, this is the first report of PBL in an atomic bomb survivor with no evidence of an immunocompromised state.