Probability scoring system of intravascular large B-cell lymphoma for the application of random skin biopsy: A retrospective cohort study

Takigawa, Mikiko; Nomura, Hayato; Miyake, Tomoko; Yanai, Hiroyuki; Morizane, Shin

doi:10.1016/j.jdin.2022.09.005

Cited by 2 publications

(8 citation statements)

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“…11 Three previous reports referred to the threshold values of highly suspicious of IVLBCL in serum sIL-2R level, and they were 2000 U/ml in two reports and 5000 U/ml in one report. 7,12,13 Our cut-off value was similar to the former one. The optimal threshold can be set at a value within four orders of magnitude.…”

Section: Discussionsupporting

confidence: 79%

“…Although less than LDH level, elevated serum sIL‐2R level is also frequently reported in IVLBCL cases 11 . Three previous reports referred to the threshold values of highly suspicious of IVLBCL in serum sIL‐2R level, and they were 2000 U/ml in two reports and 5000 U/ml in one report 7,12,13 . Our cut‐off value was similar to the former one.…”

Section: Discussionsupporting

confidence: 76%

“…In this study, we found significant differences in serum LDH and sIL‐2R levels and platelet counts in the peripheral blood between IVLBCL and non‐IVLBCL cases. The elevation of LDH level has been reported to be an important predictive factor for IVLBCL in many previous studies, 4,6,7,12 whereas the optimal threshold of the LDH level is still under debate. Sitthinamsuwan et al 6 .…”

Section: Discussionmentioning

confidence: 99%

“…To avoid missing such patients, the LDH threshold could be lower to some extent. Similarly, the criterion of LDH level >220 IU/l was included in the recent complex IVLBCL-probability scoring system for random skin biopsies proposed by Takigawa et al, 12 and Sumi-Mizuno et al 13 also suggested not to perform random skin biopsies when patients showed normal serum LDH level and serum sIL-2R levels lower than 500 U/ml. sIL-2R is generated by the proteolytic cleavage of membranous IL-2R alpha chain (CD25) expressed by activated lymphocytes and some lymphoid tumor cells.…”

Section: Discussionmentioning

confidence: 99%

“…Our system includes laboratory factors alone and is easy to use in clinical settings compared to the previous complex scoring system, including 11 general and organ-specific symptoms and two laboratory factors. 12 If the score is 0 or 1, the case may not be IVLBCL. Cases with a score of 2 or 3 indicate the possibility of IVLBCL, and the probability of the disease is high, especially in cases with a score of 3.…”

Section: Discussionmentioning

confidence: 99%

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Predictive factors and scoring system for intravascular large B‐cell lymphoma among suspected cases: a single‐center retrospective analysis

Tanaka,

Miyagaki,

Okano

et al. 2023

Int J Dermatology

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BackgroundAlthough the utility of random skin biopsies in the diagnosis of intravascular large B‐cell lymphoma (IVLBCL) has been confirmed, the patients who should undergo random skin biopsies remain unclear.ObjectivesTo assess predictive factors for IVLBCL and establish a scoring system for the applicability of random skin biopsies.MethodsWe conducted a retrospective case–control study of IVLBCL‐suspected patients who underwent random skin biopsies between April 2010 and March 2022. We compared the general symptoms, imaging findings, and laboratory findings between IVLBCL and non‐IVLBCL cases.ResultsFifty‐three patients were enrolled in this study. Eight patients were diagnosed with IVLBCL, and 35 patients were diagnosed with other diseases. The final diagnosis was unclear in 10 patients. There were no significant differences in the frequency of general symptoms and imaging findings between IVLBCL and non‐IVLBCL cases. Among laboratory findings, IVLBCL cases showed significantly higher serum lactate dehydrogenase (LDH) and soluble IL‐2 receptor (sIL‐2R) levels and lower platelet counts than non‐IVLBCL cases. We established a scoring system to predict IVLBCL by using these three parameters. The cut‐off values were as follows: serum LDH level, 256 IU/l; serum sIL‐2R level, 2011 U/ml; and platelet count, 107 × 109/l. IVLBCL was not included in patients with scores of <2. The probabilities of IVLBCL in patients with scores 2 and 3 were 18% and 86%, respectively.ConclusionsOur simple scoring system can help clinicians determine the applicability of random skin biopsies in IVLBCL‐suspected cases.

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