Intravascular lymphoma presenting as a longitudinally-extensive myelitis: Diagnostic challenges and etiologic clues

Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature

“…Additionally, we observed that IVLBCL can manifest as hyperintense lesions in both supratentorial and infratentorial structures. Remarkably, nearly half of the patients in our study had longitudinally extensive myelopathy, a finding that corroborates several case reports of intravascular lymphoma 17 18. This distinctive finding should be considered during the differential diagnosis of longitudinally extensive myelopathy, such as neuroinflammatory diseases, particularly neuromyelitis optica spectrum disorder 19.…”

Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature

“…Additionally, we observed that IVLBCL can manifest as hyperintense lesions in both supratentorial and infratentorial structures. Remarkably, nearly half of the patients in our study had longitudinally extensive myelopathy, a finding that corroborates several case reports of intravascular lymphoma 17 18. This distinctive finding should be considered during the differential diagnosis of longitudinally extensive myelopathy, such as neuroinflammatory diseases, particularly neuromyelitis optica spectrum disorder 19.…”

Clinical Reasoning: A 70-year-old man with rapid stepwise paraparesis and sensory loss

“…7,8 The initial T2-hyperintensity with delayed contrast enhancement has been described previously and likely relates to ischemic injury from accumulation of lymphomatous cells within the lumina followed by breakdown of the blood-cord barrier leading to contrast enhancement. 8 Corticosteroids, IV immunoglobulin, and PLEX have demonstrated temporary improvement. 8,10 The broad phenotypic presentation and rarity make IVL difficult to diagnose.…”

Long Spinal Cord Lesions Caused by Venous Congestive Myelopathy Associated with Intravascular Large B-cell Lymphoma

“…However, as was seen in the present case, steroid therapy was not very effective in all four of the previously reported patients who received it ( 3 - 8 ) ( Table 3 ). This may be due to the fact that irreversible vascular-related lesions frequently develop in the spinal cord of patients with IVLBCL ( 3 , 5 , 12 , 13 ), meaning that efficacy and functional outcome would depend on the size of the stroke lesion in each case. Therefore, to improve the functional prognosis, IVLBCL needs to be identified early before the lesion expands.…”

Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature

“…Additionally, we observed that IVLBCL can manifest as hyperintense lesions in both supratentorial and infratentorial structures. Remarkably, nearly half of the patients in our study had longitudinally extensive myelopathy, a finding that corroborates several case reports of intravascular lymphoma 17 18. This distinctive finding should be considered during the differential diagnosis of longitudinally extensive myelopathy, such as neuroinflammatory diseases, particularly neuromyelitis optica spectrum disorder 19.…”

Clinical Reasoning: A 70-year-old man with rapid stepwise paraparesis and sensory loss

“…7,8 The initial T2-hyperintensity with delayed contrast enhancement has been described previously and likely relates to ischemic injury from accumulation of lymphomatous cells within the lumina followed by breakdown of the blood-cord barrier leading to contrast enhancement. 8 Corticosteroids, IV immunoglobulin, and PLEX have demonstrated temporary improvement. 8,10 The broad phenotypic presentation and rarity make IVL difficult to diagnose.…”

Long Spinal Cord Lesions Caused by Venous Congestive Myelopathy Associated with Intravascular Large B-cell Lymphoma

“…However, as was seen in the present case, steroid therapy was not very effective in all four of the previously reported patients who received it ( 3 - 8 ) ( Table 3 ). This may be due to the fact that irreversible vascular-related lesions frequently develop in the spinal cord of patients with IVLBCL ( 3 , 5 , 12 , 13 ), meaning that efficacy and functional outcome would depend on the size of the stroke lesion in each case. Therefore, to improve the functional prognosis, IVLBCL needs to be identified early before the lesion expands.…”

Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature

“…Additionally, we observed that IVLBCL can manifest as hyperintense lesions in both supratentorial and infratentorial structures. Remarkably, nearly half of the patients in our study had longitudinally extensive myelopathy, a finding that corroborates several case reports of intravascular lymphoma 17 18. This distinctive finding should be considered during the differential diagnosis of longitudinally extensive myelopathy, such as neuroinflammatory diseases, particularly neuromyelitis optica spectrum disorder 19.…”

Clinical Reasoning: A 70-year-old man with rapid stepwise paraparesis and sensory loss

“…7,8 The initial T2-hyperintensity with delayed contrast enhancement has been described previously and likely relates to ischemic injury from accumulation of lymphomatous cells within the lumina followed by breakdown of the blood-cord barrier leading to contrast enhancement. 8 Corticosteroids, IV immunoglobulin, and PLEX have demonstrated temporary improvement. 8,10 The broad phenotypic presentation and rarity make IVL difficult to diagnose.…”

Long Spinal Cord Lesions Caused by Venous Congestive Myelopathy Associated with Intravascular Large B-cell Lymphoma

“…However, as was seen in the present case, steroid therapy was not very effective in all four of the previously reported patients who received it ( 3 - 8 ) ( Table 3 ). This may be due to the fact that irreversible vascular-related lesions frequently develop in the spinal cord of patients with IVLBCL ( 3 , 5 , 12 , 13 ), meaning that efficacy and functional outcome would depend on the size of the stroke lesion in each case. Therefore, to improve the functional prognosis, IVLBCL needs to be identified early before the lesion expands.…”