Intravascular large B cell lymphoma with hepatic portal vein, splenic vein and mesenteric vein tumour embolism

Yasuda, Hajime; Ando, Jun; Matsumoto, Takeshi; Ogura, K.; Ozaki, Yuka; Aritaka, Nanae; Aoki, Yuji; Sugita, Manabu; Nomura, Tomohisa; Sekii, Hajime; Yamaguchi, Naotaka; Iguchi, Shigekazu; Yamamoto, Takahiro; Komatsu, Norio; Hirano, Takao

doi:10.1111/j.1365-2559.2010.03660.x

Cited by 12 publications

(9 citation statements)

References 6 publications

(9 reference statements)

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“…As expected, no tumor cells were seen in this area. Similar findings were reported by Yasuda et al (16), who described multiple thrombotic lesions in the hepatic vessels and splenic vein at autopsy; these lesions were seen on the CT studies performed in the antemortem period and confirmed in the postmortem period. These findings suggest that, if a diagnosis of hepatic IVL is suspected when employing multiple imaging modalities, a tumor lesion-specific liver biopsy should be performed to confirm the presence of sinusoidal invasion, because a random liver biopsy may fail to detect tumor cells if it is performed in peripheral lesions (as evidenced in our case).…”

Section: Discussionsupporting

confidence: 90%

“…The patient was successfully treated with chemotherapy following the histological diagnosis of hepatic IVL (13). However, due to the difficulty in confirming the suspicion of liver invasion using imaging studies and biopsy methods, to date the number of cases involving the liver diagnosed in the antemortem period is lower than that observed in the postmortem period (12)(13)(14)(15)(16)(17)(18)(19)(20)(21) (Table). Our literature review of hepatic IVL cases diagnosed using imaging studies of the liver revealed that six of 10 cases were diagnosed at autopsy, and no specific findings were observed in the conventional CT studies (Table).…”

Section: Discussionmentioning

confidence: 99%

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Early Diagnosis of Hepatic Intravascular Lymphoma: A Case Report and Literature Review

et al. 2014

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Hepatic intravascular large B-cell lymphoma (IVL) is a rare disease entity that involves invasion into various organs. Due to the aggressive behavior and poor prognosis of the disease and the difficulty in making an early diagnosis, some cases are diagnosed at autopsy. Early suspicion and the use of imaging studies and liver biopsies are key for diagnosing IVL; however, no reports have described the results of imaging studies due to the limited number of cases. We herein report the results of imaging studies of hepatic IVL, including the findings PET-CT, dynamic-CT, EOB-MRI and CEUS. These results may help physicians to make an early diagnosis and improve the prognosis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Hepatic Intravascular Lymphoma: A Case Report and Literature Review

et al. 2014

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“…Lymph node inflammatory proliferation is considered with multiple bilateral neck and mediastinum lymph nodes enlargement. This indicates the occlusion of lymphoma cells in the vasculature, causing thrombosis and multiple system dysfunctions [9]. The enlarged lymph nodes may block drainage of fluid that lubricates the pelvic cavity, causing effusion accumulations and symptoms such as lower limb edema, pelvic effusion, and anorexia.…”

Section: Discussionmentioning

confidence: 99%

Intravascular large B-cell lymphoma of the kidney: A case report

Bai

Wan

et al. 2011

Diagn Pathol

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We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months.She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L), serum albumin of 2.89 g/dL (28.9 g/L), urea nitrogen of 2.24 mg/dL (1.6 mmol/L), and serum creatinine of 0.54 mg/dL (48 μmol/L). Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT) showed marked bilateral swelling and enlargement of the renal parenchyma with splenic enlargement and involvement of multiple vertebrae. Percutaneous renal biopsy showed island-like accumulations of medium to large lymphoid cells in many areas of the interstitium, with round vesicular nuclei containing distinct basophilic nucleoli. Immunohistochemical analysis together with other supportive investigation confirmed the diagnosis of intravascular large B-cell lymphoma. Ten days later, she was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, leurocristime and prednisone) for a week. Palliative radiotherapy DT 40Gy/20F with other supportive treatment was provided for metastatic foci in the medullary cavity of the sternum, T1-T7. The patient regained muscle strength in both lower limbs and was able to walk again after three weeks. The patient was discharged after hepatic and renal function and proteinuria values had returned to normal. Follow-up data shows the patient to be alive nine months after discharge.

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“…To date, only 3 cases of IVLBCL-associated acute abdomen have been reported. In 2 of the 3 cases, the occlusion was observed in the mesenteric vein [13,14]; in the third case, the hepatic portal, splenic, and mesenteric veins were involved [15]. Therefore, our case showed a novel manifestation of IVLBCL, with simultaneous thrombosis of both the mesenteric artery and vein.…”

Section: Discussionmentioning

confidence: 98%

Simultaneous Thrombosis of the Mesenteric Artery and Vein as a Novel Clinical Manifestation of Intravascular Large B-Cell Lymphoma

Arima

Inoue²,

Tabata³

et al. 2014

Acta Haematol

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A 79-year-old man with a 2-month history of fever and weight loss was admitted to our hospital because of an acute abdomen. Abdominal CT scans showed marked sectional thickening and edema of the small intestine. On laparotomy, a 16-cm section of the small intestine was ischemic and necrotic; therefore, segmentectomy of the intestine was performed. A thrombus was noted at the stump of the mesenteric artery branch. Histopathological analysis of the resected intestine revealed fibrin thrombi in both mesenteric arteries and veins. Furthermore, a cluster of large, abnormal lymphoid cells bordering the intima of most branches of the mesenteric veins and small vessels was observed. Immunohistochemical analysis revealed that these abnormal cells were positive for CD20, leading to a diagnosis of intravascular large B-cell lymphoma (IVLBCL). The patient was successfully treated with standard R-CHOP chemotherapy; however, the lymphoma recurred in the central nervous system 18 months after the initial diagnosis, and the patient died. Simultaneous thrombosis of the mesenteric artery and vein is unusual as a clinical manifestation of IVLBCL. However, IVLBCL should be taken into consideration when ischemic disorders of unknown cause, accompanied by fever of unknown origin, are encountered.

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Intravascular large B cell lymphoma with hepatic portal vein, splenic vein and mesenteric vein tumour embolism

Abstract: 1. Mutter GL, Baak JPA, Crum CP, Richart RM, Ferenczy A, Farquir W. Endometrial precancer diagnosis by histopathology, clonal analysis and computerized morphometry.

Cited by 12 publications

References 6 publications

Early Diagnosis of Hepatic Intravascular Lymphoma: A Case Report and Literature Review

Early Diagnosis of Hepatic Intravascular Lymphoma: A Case Report and Literature Review

Intravascular large B-cell lymphoma of the kidney: A case report

Simultaneous Thrombosis of the Mesenteric Artery and Vein as a Novel Clinical Manifestation of Intravascular Large B-Cell Lymphoma

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