Random skin biopsy in the diagnosis of intravascular lymphoma

Sitthinamsuwan, Panitta; Chinthammitr, Yingyong; Pattanaprichakul, Penvadee; Sukpanichnant, Sanya

doi:10.1111/cup.12984

Cited by 24 publications

(37 citation statements)

References 23 publications

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“…In agreement with previous reports [6,18,23,24], we found comparable age at diagnosis (67 years old) but slightly older than other Asians [4,11,20]. A slight male predominance which is consistent with studies from Thailand [11,20], Taiwan [4], and China [22] was observed in our study, although studies by Murase et al [24] and Rajyaguru et al [21] showed no gender preference. Fever was found in the majority of patients while neurologic abnormalities were also relatively common in this study.…”

supporting

confidence: 93%

“…Regarding bone marrow study, although a recent series of IVLBCL patients diagnosed by random skin biopsy showed no BM involvement [11], we found approximately 35% with BM infiltration which is consistent with previous studies ranging from 26.7% to 100% [4,6,20,22,24,26,27]. Additionally, we found that increased sera LDH and ferritin were exceedingly common in IVLBCL patients, consistent with earlier publications reporting 75%-100% of elevated LDH [5,11,20,22,23,26] and 80-100% of elevated ferritin [4,26] in IVLBCL patients.…”

supporting

confidence: 92%

“…Nonetheless, random skin biopsy (RSB) has been proposed as a useful diagnostic tool in IVLBCL by Gill et al [7]. Subsequent studies also confirmed the potential of RSB in establishing the diagnosis of IVLBCL [8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Concurrent Expression of C-MYC and BCL2 in Intravascular Large B-Cell Lymphoma: A 10-Year Retrospective Study

Boonsakan

Iamsumang

Chantrathammachart

et al. 2020

BioMed Research International

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Background. Intravascular large B-cell lymphoma (IVLBCL) is a variant of extranodal diffuse large B-cell lymphoma (DLBCL), characterized by the presence of a B-lymphoma cell in the lumina of small blood vessels or capillaries. Due to its extremely variable clinical manifestations, IVLBCL typically results in a delayed diagnosis and poor disease prognosis. Skin biopsy, particularly random skin biopsy, has shown a potential role in the diagnosis of IVLBCL. However, information of clinicopathological features in patients with IVLBCL diagnosed by skin biopsy is limited. Objectives. To study the clinicopathological features in relation to immunohistochemical features and to identify prognostic factors in IVLBCL patients diagnosed by skin biopsy. Materials and Methods. Clinical characteristics; laboratory, histological, and immunohistochemical findings; and therapeutic response of all biopsy-confirmed IVLBCL patients during the years 2008-2017 were retrospectively reviewed. Results. The mean age was 67.4 (±9.8) years. Fever was the most common presenting symptom, accounting for 64.7%. Cutaneous and bone marrow involvement was found in 23.5% and 35.3% of patients, respectively. Patients receiving R-CHOP showed more favorable therapeutic outcome. C-MYC/BCL2 double expressors showed significantly higher incidence rate to mortality compared with nondouble expressors (p=0.042). One-year and two-year overall survival rates were 67.2% and 53.8%, respectively. Conclusions. Skin biopsy is an effective diagnostic method for IVLBCL. Concurrent expression of C-MYC and BCL2 may be a useful prognostic indicator and should be performed in order to predict the prognosis in IVLBCL patients.

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confidence: 93%

supporting

confidence: 92%

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Prognostic Value of Concurrent Expression of C-MYC and BCL2 in Intravascular Large B-Cell Lymphoma: A 10-Year Retrospective Study

Boonsakan

Iamsumang

Chantrathammachart

et al. 2020

BioMed Research International

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“…Since Ferreri et al () comprehensively described the clinical features of IVLBCL 15 years ago, the number of reported cases of IVLBCL has increased in both Asian (Pongpudpunth et al , ; Sitthinamsuwan et al , ) and Western (Cho et al , ) countries. However, due to the small sample size (Arai et al , ), heterogeneity of diagnostic modalities (Ha et al , ; Brunet et al , ), cross‐sectional design in the reported multi‐institutional studies (Ferreri et al , ; Murase et al , ; Shimada et al , ; Brunet et al , ) and early diagnosis by the use of RSB, we feel that the current studies reported in the literature do not depict an accurate clinical representation of IVLBCL.…”

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confidence: 99%

Diagnosis of intravascular large B cell lymphoma: novel insights into clinicopathological features from 42 patients at a single institution over 20 years

et al. 2019

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Summary This study aimed to clarify the comprehensive clinical, laboratory, pathological and imaging features of intravascular large B‐cell lymphoma (IVLBCL) using data on 42 IVLBCL patients diagnosed at our hospital over the past 20 years. The majority of patients were diagnosed via random skin biopsy (29/42, 69·0%) followed by bone marrow biopsy alone (8/42, 19·0%). Characteristic features included persistent fever (41/42, 97·6%), decreased performance status (≥2) (100%), hypoxaemia (32/40, 80·0%), impaired consciousness (19/42, 45·2%), hypoalbuminemia (42/42, 100%) and extreme elevation of lactate dehydrogenase and soluble interleukin 2 receptor levels. Brain magnetic resonance imaging showed abnormal findings in 32/37 patients (86·4%). Hyperintense lesion in the pons was a peculiar finding that was unrelated to the neurological deficits. Positron emission tomography‐computed tomography revealed a high incidence of bone marrow (26/34, 76·5%), spleen (19/34, 55·9%) and adrenal gland (9/34, 26·5%) involvement. Neurolymphomatosis was noted in 6 patients during the course of the disease. About 60% of IVLBCL patients in whom in vivo diagnosis was possible survived more than 5 years with combination chemotherapy. Our observations provide additional insight into the diagnosis of IVLBCL and indicate that early disease recognition via random skin biopsy combined with imaging, enables in vivo diagnosis of the disease and improved survival for many patients.

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“… 9 Most Asian patients have no cutaneous lesions. 10 Even if no skin lesions are present, a random skin biopsy is a useful tool for the diagnosis of IVLBCL because it can detect tumor cells within intradermal and subcutaneous vessels. Herein, we present a case of IVLBCL that presented with hypoxemia without obvious lung lesions.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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Random skin biopsy in the diagnosis of intravascular lymphoma

Cited by 24 publications

References 23 publications

Prognostic Value of Concurrent Expression of C-MYC and BCL2 in Intravascular Large B-Cell Lymphoma: A 10-Year Retrospective Study

Prognostic Value of Concurrent Expression of C-MYC and BCL2 in Intravascular Large B-Cell Lymphoma: A 10-Year Retrospective Study

Diagnosis of intravascular large B cell lymphoma: novel insights into clinicopathological features from 42 patients at a single institution over 20 years

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

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