Plasmablastic lymphoma presenting as a soft tissue mass associated with a chronic wound in an immunocompetent patient

Plasmablastic lymphoma (PBL) is a rare aggressive type of non-Hodgkin lymphoma that primarily affects human immunodeficiency virus (HIV)–positive patients but can arise in other immunocompromised states such as transplant recipients, as well as in immunocompetent patients. The neoplastic cells express an immunophenotype that resembles plasma cells, in that they usually do not express CD20 (or may be weakly positive) but do express markers of plasmacytic differentiation such as CD38, CD138, or MUM1/IRF4. These tumors generally have high mitotic activity, evidenced by a high Ki-67 proliferation index. Epstein-Barr virus (EBV) is frequently detected within the tumor and is thought to have a pathogenic role in the development of PBL. The earliest descriptions of PBL were as oral cavity lesions. PBL most frequently present as a mass in extranodal regions of the head and neck. Presentation as a soft tissue mass is very uncommon. In this article, we present an immunocompetent 50-year-old male patient who presented with a soft tissue left heel mass in the setting of chronic ulceration, subsequently diagnosed as PBL.