Case 36: A difficult diagnosis in a patient with fever and progressive multi-organ failure

Gabriel, Ian; Chong, Nick; Rice, Alexandra; Negus, Rupert; Bain, Barbara J.

doi:10.1080/10428190701342703

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Skeletal involvement of IVLBCL has already been described with FDG‐PET/CT. As in our case, multifocal bone accumulation of FDG is the most common finding , whereas diffuse uptake is less frequently reported . False negative of FDG‐PET may occur in pathologically proven bone infiltration and also with bone marrow biopsy, which is not the most efficient method for the diagnosis of IVLBCL .…”

Section: Discussionsupporting

confidence: 87%

FDG-PET/CT is a pivotal imaging modality to diagnose rare intravascular large B-cell lymphoma: case report and review of literature

et al. 2014

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Intravascular large B-cell lymphoma (IVLBCL) remains a diagnostic challenge, because of non-specific findings on clinical, laboratory, and imaging studies. We present a case in which 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography was particularly useful to suspect the diagnosis, to detect unexpected locations, to guide contributive biopsy, and to assess the response to treatment. In case of initial negative results, FDG-PET should be repeated in the course of clinical evolution. In the presence of neurological or hormonal symptoms without brain magnetic resonance imaging abnormality, FDG-PET brain slices could depict additional pituitary and/or brain hypermetabolisms. We discuss the potential interests of FDG-PET in IVLBCL by a literature review.

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Section: Discussionsupporting

confidence: 87%

FDG-PET/CT is a pivotal imaging modality to diagnose rare intravascular large B-cell lymphoma: case report and review of literature

et al. 2014

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“…At present, 28 cases of PML have been reported in the English literature in patients who have undergone an allogeneic stem cell transplantation from 1958 to 2016 (Table ) . The median age of patients was 43 years (range: 14‐77 years), and the time to the manifestation of symptoms ranged from 1 to 60 months (median: 8 months).…”

Section: Discussionmentioning

confidence: 99%

Progressive multifocal leukoencephalopathy after allogeneic stem cell transplantation: Case report and review of the literature

Yuan

Deberardinis

Patel

et al. 2018

Transplant Infectious Dis

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Progressive multifocal leukoencephalopathy (PML) is a rare, yet typically fatal complication of allogeneic stem cell transplantation. It is caused by reactivation of the John Cunningham (JC) virus in an immunocompromised host. This report describes an unfortunate case of PML in a recipient of an allogeneic stem cell transplant for acute myelogenous leukemia. The JC virus was undetectable in the patient's cerebrospinal fluid by polymerase chain reaction (PCR); however, a positive diagnosis was made after a brain biopsy. This and other published cases demonstrate that recipients of allogeneic stem cells can develop PML. Moreover, early diagnosis of the disease is often difficult and, as demonstrated in this case, screening with PCR does not appear to have strong diagnostic significance. With no effective treatment presently available, restoration of immune function is the only intervention that can affect prognosis. Further prospective studies are needed to understand the pathophysiology and treatment of this disease.

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Pulmonary Intravascular Large B-cell Lymphoma (IVLBCL) Disguised as an Asthma Exacerbation in a Patient with Asthma

et al. 2017

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A 62-year-old man with asthma presented with a 1-month history of wheezing and exertional dyspnea. Although the wheezing symptoms disappeared after systemic corticosteroid therapy, the exertional dyspnea and hypoxemia did not improve. A diagnosis of intravascular large B-cell lymphoma (IVLBCL) with pulmonary involvement was suspected because of the increased serum lactic dehydrogenase (LDH) and soluble interleukin-2 receptor (sIL-2R) level, increased alveolar-arterial oxygen difference (AaDO2), decreased pulmonary diffusing capacity for carbon monoxide (DLCO) and scintigraphic, computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT findings. The patient was diagnosed as having IVLBCL with pulmonary involvement based on a pathological analysis of a random skin biopsy and a transbronchial lung biopsy. IVLBCL should be considered in patients with symptoms of asthma that are refractory to corticosteroid treatment.

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Case 36: A difficult diagnosis in a patient with fever and progressive multi-organ failure

Abstract: A man in late middle age presented with fever, systemic symptoms, raised inflammatory markers and anaemia of chronic disease. Despite two months of investigation, the diagnosis of a haematological malignancy was made only at autopsy.

Cited by 3 publications

References 8 publications

FDG-PET/CT is a pivotal imaging modality to diagnose rare intravascular large B-cell lymphoma: case report and review of literature

FDG-PET/CT is a pivotal imaging modality to diagnose rare intravascular large B-cell lymphoma: case report and review of literature

Progressive multifocal leukoencephalopathy after allogeneic stem cell transplantation: Case report and review of the literature

Pulmonary Intravascular Large B-cell Lymphoma (IVLBCL) Disguised as an Asthma Exacerbation in a Patient with Asthma

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