An Asian variant of intravascular large B-cell lymphoma: clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome

Murase, Takuhei; Nakamura, Shigeo; Kawauchi, Kiyotaka; Matsuzaki, Hiromitsu; Saito, Chikara; Inaba, Tohru; Nasu, K; Tashiro, Kazuhiro; Suchi, Taizan; Saito, Hidehiko

doi:10.1046/j.1365-2141.2000.02426.x

Cited by 132 publications

(156 citation statements)

References 27 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…Chromosomeanalysis of the bone marrow cells in the present case showed extremely complex abnormalities mixed with a normal karyotype (Fig 6). The hypotetraploidy might suggest gains involving chromosome 18, which has been reported as a candidate for common chromosome abnormalities in the AIVL (14). In addition, 8p21 and 19ql3, both of which Shimazaki et al reported as characteristic chromosome abnormalities in their cases of DLBLwith HPS, are also involved in the present case (18).…”

Section: Case Reportmentioning

confidence: 57%

“…The pathologic diagnosis of IVL was based on the intravascular and sinusoidal involvement of neoplastic large B-cells in the liver wedge biopsy, making the diagnosis of AIVLstrongly indicated from the clinical viewpoint. Wehave recently proposed diagnostic criteria for AIVL for the purpose of early diagnosis and prospective studies of this disease (Table 1) (14). The present case, on the second admission, did not match for "criterion I.e.…”

Section: Case Reportmentioning

confidence: 72%

“…HPS has been reported in association with various malignant conditions, especially with peripheral T-cell lymphoma, nasal NK/T cell lymphoma, anaplastic large cell lymphoma and DLBLincluding AIVL (12)(13)(14). The pathologic diagnosis of IVL was based on the intravascular and sinusoidal involvement of neoplastic large B-cells in the liver wedge biopsy, making the diagnosis of AIVLstrongly indicated from the clinical viewpoint.…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Asian Variant of CD5+ Intravascular Large B-cell Lymphoma with Splenic Infarction.

Tokura¹,

Murase²,

Toriyama³

et al. 2003

Intern. Med.

Self Cite

View full text Add to dashboard Cite

A 57-year-old man was admitted with fever and epigastralgia, and presented with splenomegaly and pancytopenia. A CTscan revealed splenic infarctions. There were no lymphadenopathies, skin lesions, or neurological abnormalities. A splenectomy was performed. Bone marrow involvement with hemophagocytosis was noted. The diagnosis of Asian variant of intravascular diffuse large B-cell lymphomawas based on intravascular and sinusoidal distribution of large CD5+B cells. The patient died of the disease ll months after onset. To our knowledge, this is the first report of AIVL that presented with splenic infarction. This distinct lymphoma should be included in the differential diagnosis of splenic infarction. (Internal Medicine 42: 105-109, 2003)

show abstract

Section: Case Reportmentioning

confidence: 57%

Section: Case Reportmentioning

confidence: 72%

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Asian Variant of CD5+ Intravascular Large B-cell Lymphoma with Splenic Infarction.

Tokura¹,

Murase²,

Toriyama³

et al. 2003

Intern. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…[12][13][14] These include a purportedly distinct variant of intrasinusoidal splenic LBCL occurring primarily in Asians which is associated with histocytic proliferation, prominent hemophagocytosis, and aggressive behavior. [15][16][17] The nature of these latter cases remains unclear and it has been speculated that some may represent a variant of intravascular LBCL.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma with distinctive patterns of splenic and bone marrow involvement: clinicopathologic features of two cases

2005

View full text Add to dashboard Cite

Two unusual cases of large B-cell lymphoma with predominant splenic and bone marrow (BM) involvement and similar clinical and histopathologic features are described. Both patients presented with nonspecific constitutional symptoms, unexplained cytopenias, and splenomegaly. Splenectomy revealed diffuse red pulp involvement by large B-cell lymphoma. The perisplenic lymph nodes were also involved diffusely with effacement of normal nodal architecture, excluding a diagnosis of intravascular large B-cell lymphoma. BM biopsies revealed striking erythroid hyperplasia without overt morphologic evidence of involvement by lymphoma. Immunoperoxidase staining of the marrow biopsies with antibodies to CD20 and erythroidassociated antigens revealed involvement by large B-cell lymphoma morphologically resembling the early pronormoblasts. In both cases there was prominent, but not exclusive, intravascular/intrasinusoidal lymphomatous marrow infiltration. These cases represent an unusual variant of large B-cell lymphoma with distinctive patterns of splenic and BM involvement. Furthermore, they underscore the difficulties in identifying intrasinusoidal marrow infiltration by lymphoma in H&E-stained biopsy slides and demonstrate that this pattern of marrow infiltration may be seen in cases of large B-cell lymphoma distinct from the intravascular variant. Keywords: diffuse large B-cell lymphoma; intravascular lymphoma; spleen; bone marrow; erythroid hyperplasia; non-Hodgkin lymphoma Diffuse large B-cell lymphoma (LBCL) can involve nodal or extranodal sites; however, initial presentation in the spleen occurs infrequently. 1 Typically when diffuse LBCL involves the spleen it forms discrete tumoral masses within the splenic parenchyma. 2 A recent report detailed other less common patterns of splenic involvement by LBCL including diffuse infiltration of the splenic red pulp. 3 The clinicopathologic features of diffuse LBCL with these unusual patterns of splenic involvement have yet to be fully elucidated. Described herein are the distinctive clinical and histopathologic features of two cases of splenic LBCL with diffuse red pulp infiltration and concurrent involvement of lymph nodes and bone marrow (BM). These cases had strikingly similar clinical presentations chiefly characterized by dyspnea, unexplained cytopenias, and splenomegaly. In both instances, splenectomy performed to alleviate the cytopenias revealed diffuse, homogeneous involvement of the splenic red pulp by diffuse LBCL. Although the pattern of splenic red pulp involvement and the clinical features raised the possibility of intravascular LBCL, in both cases there was parenchymal involvement of splenic hilar lymph nodes, excluding this diagnosis as defined by the most recent WHO criteria. 4 Furthermore, both cases had prominent BM involvement by lymphoma, which was difficult to detect by routine morphologic evaluation of hematoxylin and eosin (H&E)-stained biopsy slides. This difficulty was due both to the presence of prominent erythroid hyperplasia as well as a predominan...

show abstract

“…Prognosis is uniformly poor with better outcomes observed with the ''cutaneous variant,'' which is associated with skin lesions in the absence of systemic involvement [6][7][8][9]. An ''Asian variant'' of the disease mostly reported in the Japanese literature differs from the presentation of IVL in the Western literature as it is associated with a hemophagocytic syndrome, bone marrow involvement, hepatosplenomegaly, and thrombocytopenia, while cutaneous and CNS lesions are uncommon [15,16]. IVL is considered a disseminated disease and treatment with combination chemotherapy including anthracyclines is recommended along with inclusion of methotrexate or cytarabine when there is CNS involvement [7].…”

Section: Commentarymentioning

confidence: 99%

A 69‐year‐old male presenting with hypotension and anasarca

et al. 2007

View full text Add to dashboard Cite

A 69-year-old Caucasian male with a past medical history remarkable for hypertension and testicular nonHodgkin's lymphoma (NHL) presented to the emergency department with a 1-week history of fatigue and new onset lower extremity edema. For the past 8 months, the patient was having a nonproductive cough. Work up by his primary care physician was negative, and the patient was switched from enalapril to losartan 1 week before presentation. The cough resolved, however, 2 days later the patient began to experience fatigue and lightheadedness that persisted despite decreasing the dose of losartan. He continued to develop lower extremity edema and was again seen by his primary care physician who noted the patient to be hypotensive. He was referred to the emergency department for evaluation.In a 69-year-old male presenting with fatigue, lower extremity edema, and hypotension, our first concern was for a cardiac process such as heart failure. The differential for his hypotension also included sepsis, adrenal insufficiency, hemorrhage, or possibly an adverse drug reaction. We suspected that his cough was secondary to the enalapril as his symptoms had resolved with discontinuation of this medication; however, we remained concerned that an underlying pulmonary process could also be present.The patient denied chest pain, orthopnea, paroxysmal nocturnal dyspnea, fever, weight loss, or night sweats. His testicular NHL was treated 16 years prior with orchiectomy and four cycles of CHOP without evidence of recurrence. In addition to losartan, the patient also took a daily aspirin. He was a retired carpenter who had a 19-pack year smoking history and had quit 37 years before presentation. He occasionally drank alcohol. He denied illicit drug use. On examination, he was not in distress. His weight was 80.2 kg. His temperature was 36.48C, pulse 130 and regular, respiratory rate 18, blood pressure 78/46, and oxygen saturation was 97% while breathing ambient air. Physical examination was remarkable for a normal jugular venous pressure, tachycardia without extra heart sounds and generalized anasarca including 2+ pitting edema of his lower extremities. There was no lymphadenopathy, palpable masses, or cutaneous lesions. His neurologic examination was normal.The patient's review of systems was negative for symptoms of an acute coronary syndrome or heart failure, as well as for B-symptoms or a rapidly progesssive infectious process. On physical examination, his vital signs suggested intravascular volume depletion with tachycardia and hypotension; however, he appeared to have a component of fluid overload or third spacing of fluids with the marked degree of anasarca. His normal jugular venous pressure suggested normal right heart pressure making a cardiac cause of his anasarca less likely.The patient's white cell count was 12,300/mm 3 , with 93% neutrophils, 1% bands, and 6% monocytes. The hemoglobin level was 11.3 g/dl, with a mean corpuscular volume of 78.8 mm 3 . The platelet count was 554,000/ mm 3 . The serum sodium level was 126 mmo...

show abstract

An Asian variant of intravascular large B-cell lymphoma: clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome

Cited by 132 publications

References 27 publications

Asian Variant of CD5+ Intravascular Large B-cell Lymphoma with Splenic Infarction.

Asian Variant of CD5+ Intravascular Large B-cell Lymphoma with Splenic Infarction.

Diffuse large B-cell lymphoma with distinctive patterns of splenic and bone marrow involvement: clinicopathologic features of two cases

A 69‐year‐old male presenting with hypotension and anasarca

Contact Info

Product

Resources

About