Diagnostic Problem of Facial Malignancy in The Elderly: A rare case

Introduction: Lymphoma can occur in adults and the elderly, this will affect the condition of both diagnosis and therapy. Plasmablastic lymphoma (PBL) is a subtype of diffuse large B-cell lymphoma (DLBCL), the case is rarely found and often overlaps the anatomical pathology picture similar to plasmacytoma. It is aggressive and often relapses. Case Presentation: A 50-year-old man, complained of a lump on the right cheek extending to the left cheek and left eye. Irregular shape, hard, painful, accompanied by lumps of the right and left submandibular glands, difficulty breathing and swallowing, so a tracheostomy and gastrostomy were performed. The first anatomical pathology results in extraosseous Plasmacytoma and the second Plasmablastic lymphoma with IHC CD138 (+) CHOP chemotherapy and radiation. After chemotherapy, the patient experienced improvement. Conclusion: Plasmablastic lymphoma is difficult to diagnose because the anatomical pathology picture overlaps with plasmacytoma in the gold standard IHC CD138 (+), which is aggressive and relapses.