Random skin biopsy for diagnosis of intravascular large B-cell lymphoma in a patient with hypoxemia and normal lung imaging

Banjongjit, Athiphat; Chiratikarnwong, Kanokphorn; Saelue, Pirun; Sangmala, Siripan; Auepemkiate, Sauvarat; Kayasut, Kanita

doi:10.1016/j.jdcr.2017.11.013

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Early treatment by early diagnosis might improve the outcome of IVLBCL [ 23 , 25 , 28 , 29 ]. Although currently there is no consensus on best diagnosis protocol, however random skin biopsy remains the most common strategy for patients suspected with IVLBCL [ [10] , [11] , [12] , 14 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Intravascular Large B-cell lymphoma: A case series and review of literatures

et al. 2021

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Background Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma with uncommon clinical presentations and poor prognosis. The purpose of this study is to report the clinical features and outcome of IVLBCL in a single institution of Taiwan. Methods Ten patients with IVLBCL diagnosed from June 2006 to January 2018 were retrospectively reviewed. Results The median age was 61 (range 39–88) years. The most common presentation was fever (90%), cytopenia (90%), and confusion (50%). For all patients, the median progression free survival (PFS) and overall survival (OS) were 12.6 (95% confidence interval [CI] 0.0–76.1) and 18.8 (95% CI 0–59.3) months, respectively. Six patients received rituximab combined chemotherapy, and the other one patient was treated with chemotherapy alone. Six of seven (85.7%) patients achieved complete response after chemotherapy. The median PFS and OS for six patients who completed treatment were not reached. Three-year PFS and OS rates were 80% and 75%, respectively. Conclusion Our study showed that patients might achieve durable remission after rituximab-based chemotherapy. The outcome of IVLBCL patients may further improve if early diagnosis and prompt treatment were made.

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Section: Discussionmentioning

confidence: 99%

Intravascular Large B-cell lymphoma: A case series and review of literatures

et al. 2021

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“…Pulmonary infiltration by IVLBCL is known to typically show ground-glass opacity, subpleural patchy areas of consolidation and reticulonodular lesions on CT 12. However, there have been reports of cases of pulmonary infiltration with no abnormalities seen on imaging 13–15. Therefore, even if there is no abnormality on imaging, IVLBCL should be included in the differential, and further workup such as bronchoscopy should be performed.…”

Section: Discussionmentioning

confidence: 99%

Intravascular large B-cell lymphoma causing hypopituitarism and respiratory failure due to infiltration into pulmonary capillaries

et al. 2022

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We report a rare case of intravascular large B-cell lymphoma (IVLBCL) with hypopituitarism and respiratory failure. A man in his 80s presented with hypotension and respiratory failure but was unsuccessfully treated for septic shock. Biological investigations were performed, and he was diagnosed with hypopituitarism due to insufficient secretion of anterior pituitary hormone. Although his condition temporarily improved following hormone replacement therapy, he eventually died of progressive respiratory failure. The lymphoma was only discovered during the autopsy, where it was observed to have spread to the pituitary gland and lung capillaries. Therefore, we concluded that the lymphoma had caused respiratory failure and hypopituitarism. The patient was thus diagnosed with IVLBCL posthumously. In conclusion, IVLBCL can cause hypopituitarism and respiratory failure due to pituitary and pulmonary capillary invasion by lymphoma cells.

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“…Random cutaneous/subcutaneous tissue biopsy (even in the absence of skin lesions) may be a useful and minimally-invasive way to facilitate early diagnosis. 18 For a more targeted approach, PET-CT may be helpful in choosing the most FDG-avid lesions to biopsy.…”

Section: Discussionmentioning

confidence: 99%