Pulmonary Intravascular Large B-cell Lymphoma (IVLBCL) Disguised as an Asthma Exacerbation in a Patient with Asthma

Takeshige, Tomohito; Harada, Norihiro; Sekimoto, Yasuhito; Kanemaru, Ryota; Tsutsumi, Takanobu; Matsuno, Kei; Shiota, Satomi; Masuda, Azuchi; Gotoh, Akihiko; Asahina, Miki; Uekusa, Toshimasa; Takahashi, Kazuhisa

doi:10.2169/internalmedicine.56.7613

Cited by 9 publications

(11 citation statements)

References 44 publications

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“…Lung involvement is relatively frequent, being present in approximately 60% of autopsy cases 2 . However, initial or predominant presentation involving the lung is rare 2 - 4 , 10 - 12 . In our case, the lung was the only organ with clinical involvement.…”

Section: Discussionmentioning

confidence: 60%

Pulmonary intravascular large B-cell lymphoma accompanying synchronous primary pulmonary adenocarcinoma and benign interstitial lesions

Satoh¹,

Arai²,

Kayano³

et al. 2019

JCEH

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Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma, and initial or predominant presentation in the lungs is uncommon. The synchronous occurrence of IVLBCL and malignant tumors is less frequent, and no such reports have described pulmonary presentations. We report a rare case of pulmonary IVLBCL accompanying lung cancer and interstitial lesions. A 73-year-old man with a history of pneumonia underwent a follow-up examination. Computed tomography revealed diffuse, bilateral ground-glass opacities (GGO) with a partial solid mass. Histologically, the mass consisted of adenocarcinoma. However, two other types of interstitial lesions were scattered throughout the resected lung: 1) peribronchovascular thickening with the aggregation of macrophages and anthracosis, and 2) alveolar septal thickening in the centrilobular area with atypical CD20-positive large cells in the capillaries. These two types of lesions were not mixed. Computed tomography and positron emission tomography demonstrated no other organ involvement. The patient was considered to have the synchronous occurrence of pulmonary IVLBCL and lung cancer (adenocarcinoma). After R-CHOP therapy, GGO on CT disappeared. Lung cancer often accompanies benign background lesions, and the combination of these lesions with lung cancer may make it difficult to detect the presence of pulmonary IVLBCL. However, the histological distribution pattern of IVLBCL may be a clue to the correct diagnosis.

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Section: Discussionmentioning

confidence: 60%

Pulmonary intravascular large B-cell lymphoma accompanying synchronous primary pulmonary adenocarcinoma and benign interstitial lesions

Satoh¹,

Arai²,

Kayano³

et al. 2019

JCEH

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“…IVLBCL with exclusive involvement of the lung is uncommon. The clinical symptoms in those cases usually mimic pneumonia, asthma, or interstitial lung disease, leading to delayed biopsy, diagnosis and treatment 3. Although IVLBCL usually behaves in an aggressive clinical course, most cases with isolated organ involvement show complete remission, especially those with isolated pulmonary involvement 3.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical symptoms in those cases usually mimic pneumonia, asthma, or interstitial lung disease, leading to delayed biopsy, diagnosis and treatment 3. Although IVLBCL usually behaves in an aggressive clinical course, most cases with isolated organ involvement show complete remission, especially those with isolated pulmonary involvement 3. The dramatic prognostic difference between systemic and isolated organ involvement might indicate an unknown mechanism by which tumour cells are restricted in a specified site, and therefore are amenable to eradication.…”

Section: Discussionmentioning

confidence: 99%

Subtle lung lesion in a middle-aged woman with fever and cough

Chiang

Tsai

et al. 2019

J Clin Pathol

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“…Clinical diagnosis is extremely difficult as the presentation is non-specific. Its varied clinical presentations have earned it the title “The oncologist’s ‘Great Imitator.’”4 Numerous case reports have described its mimicking a variety of illnesses, including Guillain-Barre,5 nodular goiter,6 dementia,7 asthma exacerbation,8 and CNS vasculitis,9 among others.…”

Section: Discussionmentioning

confidence: 99%

Intravascular large B-cell lymphoma: The Great Imitator

Devitt

Gardner

2018

Autops. Case Rep.

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Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of diffuse large B-cell lymphoma with an estimated incidence of less than one per million. Unlike other hematopoietic malignancies, lymphadenopathy and hepatosplenomegaly are uncommon, and patients typically present with nonspecific symptoms. IVLBCL presents a diagnostic challenge and patients are usually diagnosed late in the disease course, if at all, and the prognosis is poor. The differential diagnosis is broad, and physicians often pursue multiple diagnostic possibilities during patient workup. We present a case of IVLBCL discovered at autopsy in an 80-year-old male who presented with history and symptoms pointing to the tick-borne illness ehrlichiosis.

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Pulmonary Intravascular Large B-cell Lymphoma (IVLBCL) Disguised as an Asthma Exacerbation in a Patient with Asthma

Cited by 9 publications

References 44 publications

Pulmonary intravascular large B-cell lymphoma accompanying synchronous primary pulmonary adenocarcinoma and benign interstitial lesions

Pulmonary intravascular large B-cell lymphoma accompanying synchronous primary pulmonary adenocarcinoma and benign interstitial lesions

Subtle lung lesion in a middle-aged woman with fever and cough

Intravascular large B-cell lymphoma: The Great Imitator

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