Liver Dysfunction and Thrombocytopenia Diagnosed as Intravascular Large B-cell Lymphoma Using a Timely and Accurate Transjugular Liver Biopsy

Sekiguchi, Nodoka; Joshita, Satoru; Yoshida, Takehiko; Kurozumi, Masahiro; Sakai, Kenji; Nakagawa, Michitaka; Ito, Tetsuya; Matsushita, Takehiko; Komatsu, Daisuke; Komatsu, Michiharu; Ito, Toshiro; Umemura, Takeji; Ikeda, Shu‐ichi; Kadoya, Masumi; Ishida, Fumihiro; Tanaka, Eiji

doi:10.2169/internalmedicine.52.0278

Cited by 18 publications

(25 citation statements)

References 15 publications

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“…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%

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: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…[5] Lymphoma cells were positive for anti-CD20 antibody, but negative for CD3 and CD5 (Figs. 1C and D).…”

Section: Case Reportmentioning

confidence: 99%

Intravascular large b-cell lymphoma diagnosed via transjugular liver biopsy in a patient with liver dysfunction and thrombocytopenia

Kim¹,

Park

Yhim

2017

Medicine

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Rationale:Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare subtype of large B-cell lymphoma characterized by the presence of lymphoma cells within the lumen of small blood vessels. IVLBCL presents with nonspecific symptoms such as fever, weight loss, and bleeding. Because of its rarity and unremarkable clinical presentation, a timely diagnosis is very challenging.Patient concerns:A 71-year-old Korean man complained of fever, but apart from pretibial pitting edema and mild thrombocytopenia, the physical examination and laboratory test findings were unremarkable.Diagnoses:A bone marrow biopsy was also nonspecific. The fever persisted and his thrombocytopenia became more pronounced, prompting further laboratory tests that indicated infiltrative liver disease.Interventions:Because of coagulopathy, a liver biopsy was performed using a transjugular instead of apercutaneous approach.Outcomes:The procedure was performed without complications, and the pathologic examination findings were consistent with IVLBCL. Unfortunately, the patient died because of disease progression before treatment could be administered.Lessons:Given that an early diagnosis can affect the prognosis of IVLBCL, quickly and safely obtaining a biopsy specimen is very important. The case presented here shows that a liver biopsy obtained via a transjugular approach is safe and could be preferentially considered when there is a high risk for bleeding complications.

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“…3,6 Although, fever may be a presenting symptom, the clinical symptoms largely reflect the ischemic sequelae of intravascular occlusion associated with the proliferating intravascular tumor cells. [8][9][10][11][12][13][14][15][16][17][18] When patients present with disease confined exclusively to the skin (ie, the so-called cutaneous variant), they carry a much better prognosis than do those who present with skin disease in the setting of multiorgan involvement. Lymph node (LN) disease is seen in only 11% of cases.…”

Section: Introductionmentioning

confidence: 99%

Unusual Variants of Intravascular Malignant Hematopoietic Neoplasms

Nguyen

Yassin

Magro

2015

The American Journal of Dermatopathology

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Intravascular lymphoma (IVL) is a rare and fatal disease, typically of B-cell origin. Most of the reported cases have been for primary IVL, and only a minority of cases are of recurrent IVL. In addition, recurrent IVL occurring after treatment of anaplastic large T-cell lymphoma (ALCL) by contrast is extraordinarily rare. In this article, we present 3 cases of recurrent cutaneous IVL (2 men and 1 woman) and compare these with 1 case of primary IVL. The patients ranged in age from 56 to 73 years and were encountered in the routine dermatopathology and consultative practices of one of the authors. In 2 of the cases, the patients had intravascular cutaneous ALCL. In regard to the remaining 2 patients, 1 patient had a recurrent intravascular cutaneous follicular lymphoma in the context of a history of diffuse large B-cell lymphoma. The fourth patient had a primary intravascular ALCL because there was no antecedent history. In all cases, the skin biopsies showed large aggregates of atypical cells within the blood vessels. Phenotypic studies revealed variable staining results with CD29 and CD54 in cases of recurrent IVL compared with those of primary IVL. Recurrent cutaneous IVL represents a somewhat heterogeneous group of lymphoproliferative disorders with a distinct variant being in the context of intravascular ALCL; the mechanisms of intravascular localization in recurrent IVL are likely different from those of primary IVL.

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Liver Dysfunction and Thrombocytopenia Diagnosed as Intravascular Large B-cell Lymphoma Using a Timely and Accurate Transjugular Liver Biopsy

Cited by 18 publications

References 15 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 diagnosed via transjugular liver biopsy in a patient with liver dysfunction and thrombocytopenia

Unusual Variants of Intravascular Malignant Hematopoietic Neoplasms

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