Intravascular Large B Cell Lymphoma Diagnosed by Senile Angioma Biopsy.

Satoh, Shunichi; Yamazaki, Masashi; Yahikozawa, Hiroyuki; Ichikawa, Naoaki; Saitô, Hiroshi; Hanyuu, Norinao; Hata, Satoru; Hachyou, Masahiro

doi:10.2169/internalmedicine.42.117

Cited by 29 publications

(17 citation statements)

References 7 publications

(9 reference statements)

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“…Colonization of preexistent cutaneous hemangiomas, similar to that observed in our patient, has been described in 2 other cases [15][16][17]. Although this is an exceptional Cerroni phenomenon, given the rarity of intravascular large B-cell lymphoma it seems to represent rather a peculiar clinicopathologic presentation of this type of lymphoma than just a chance association.…”

supporting

confidence: 86%

Hemangiomas with a (Bad) Surprise

Cerroni¹

2004

Dermatology

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supporting

confidence: 86%

Hemangiomas with a (Bad) Surprise

Cerroni¹

2004

Dermatology

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“…However, small red papules indicative of senile angioma, as in this case, are rare 7. To our knowledge, only four cases of senile angioma-like eruptions or haemangiomatous lesions in IVLBCL have been reported in the English language literature 3 , 8 – 10. These four cases, along with the case reported here, are summarised in table 1.…”

Section: Discussionmentioning

confidence: 62%

“…It primarily affects the skin and nervous system and sometimes lung and adrenal gland; however, it rarely involves the bone marrow, lymph nodes, liver and spleen, which are common targets of other lymphomas 2. IVLBCL is clinically aggressive and usually fatal, but the disease is quite difficult to diagnose while the patient is alive because the clinical symptoms, laboratory tests and biopsy specimens of bone marrow or peripheral blood smears usually show no specific findings 1 – 3. Here, we report a case of IVLBCL that could be diagnosed by a skin biopsy of a senile angioma-like eruption at an early stage and responded well to chemotherapy.…”

Section: Introductionmentioning

confidence: 93%

Intravascular large B cell lymphoma with neurological symptoms diagnosed on the basis of a senile angioma-like eruption

Nakamura

Nakamagoe²,

Kawachi³

et al. 2009

Case Reports

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Intravascular large B cell lymphoma (IVLBCL) presents various neurological symptoms, and the prognosis frequently deteriorates with a delay in diagnosis. In addition, for the diagnosis of IVLBCL, invasive biopsies are generally performed in main organs, such as the brain. We report a case of IVLBCL in which an early diagnosis was enabled by skin biopsy. The patient in this case had cauda equine syndrome and had developed multiple brain infarctions. She received six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) treatment and is currently in complete remission. At the macroscopic level, her lesions resembled senile angioma, commonly observed in normal elderly persons. Eruptions of this type are not currently recognised as IVLBCL lesions and might easily be overlooked. In cases in which IVLBCL could be suspected, an active search and biopsy of skin lesions, including an eruption of this type, are useful for early diagnosis and treatment.

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“…Satoh et al (11) showed the clinical usefulness of performing biopsy of cherry haemangiomas for the diagnosis of intravascular lymphoma (IVL). IVL is a rare subtype of extranodal diffuse large B-cell lymphoma with an aggressive clinical course, characterized histologically by predominant proliferation of lymphoma cells within the blood vessel.…”

Section: Discussionmentioning

confidence: 99%

Electron-microscopy of Cherry Haemangioma in the Early Diagnosis of Fabry Disease

Tokuriki¹,

Kiyohara²,

Kumakiri³

2013

Acta Derm Venerol

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Fabry disease (FD) is a chronically progressive, congenital metabolic disease. Deficiency of a-galactosidase A (a-gal A) results in the accumulation of glycosphingolipids in various types of cell. Most male patients with FD develop renal failure, cardiac and cerebrovascular disease, which are the major causes of morbidity and mortality, occurring in the fourth or fifth decade of life ( 1 ). Thus, it is important to diagnose and start to treat FD as promptly as possible (2). We describe here a patient with FD who presented with only a few red papules, pathologically consistent with cherry haemangioma. CASE REPORTA 27-year-old Japanese man presented with a few, solitary, 2-3-mm diameter, bright-red papules on the chest and left shoulder (Fig. lA). His mother, a 52-year-old Japanese woman, had been diagnosed with FD due to asymptomatic cardiomegaly detected during a regular medical check-up. This prompted her son also to undergo examination. A detailed medical history revealed that he had been aware of relatively mild numbness and tingling in his extremities, and oligohidrosis after strenuous exertion, since approximately 10 years of age. Histologically, the papules showed numerous moderately dilated vessels lined with flattened endothelial cells and pericytes in the subpapillary region, sparing the papillary dermis. The intervascular stroma showed homogenization ofthe collagen. The overlying epidermis was slightly thinned and there was no vessel invagination into the epidermis (Fig. IB). We could recognize neither vacuolations nortoluidine blue-stained deposits in the cytoplasm of endothelial cells or sweat gland cells. We then performed electron-microscopy of the papules, demonstrating uneven dense and lamellar deposits in the cytoplasm ofthe endothelial cells and pericytes (Fig. 2). This finding is characteristic of lysosomal storage diseases, such as FD. Laboratory tests gave the following results; plasma a-gal A activity, 0.2 nmol/h/ml (normal 6.0-10.8 nmol/h/ml); urinary GL-3, 7.06 mg/mgCr (normal < 0.26 mg/mgCr); urinary a-gal A protein, 11.2 ng/mgCr (normal >38.2 ng/mgCr). Finally, the patient was diagnosed with FD and has been receiving enzyme replacement therapy (agalsidase beta; 1 mg/kg) for nearly 3 years, given every other week, starting from 2 months after his initial consultation at our institution. To date, this therapy has prevented the disease from progressing and the patient has been able to carry out his normal activities of daily living. Fig. 1. (A) Clinical presentation: 2-miii diameter, solitary, red papule on the right ehest. (B) Histologically, red papule shows the features of eherTy haemangioma rather than those of angiokeratoma (haematoxylin-eosin staining X 100). fig. 2. Electron-dense cytoplasmic inclusion bodies within vaseularendothelia! cells and pericytes (lead hydroxide staining, original magnification x 4.000).

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Intravascular Large B Cell Lymphoma Diagnosed by Senile Angioma Biopsy.

Cited by 29 publications

References 7 publications

Hemangiomas with a (Bad) Surprise

Hemangiomas with a (Bad) Surprise

Intravascular large B cell lymphoma with neurological symptoms diagnosed on the basis of a senile angioma-like eruption

Electron-microscopy of Cherry Haemangioma in the Early Diagnosis of Fabry Disease

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