The use of blind skin biopsy in the diagnosis of intravascular B-cell lymphoma

Linfoma intravascular de células B grandes: hallazgos clínicos y morfológicos en un caso con desenlace fatal

“…Las alteraciones neuroló-gicas, sin embargo, pueden ser muy variables, correspondiendo habitualmente a una encefalopatía subaguda, accidentes cerebro-vasculares multifocales y neuropatía periférica y/o craneal; siendo la RM el examen de mayor utilidad, a pesar de su baja sensibilidad y especifi cidad 1,2,[8][9][10][11][12][13] . El compromiso cutáneo se reporta casi en la mitad de los casos, correspondiendo generalmente a pápulas violáceas, nódulos ulcerados o placas eritematosas, constituyendo el estudio histopatológico de ellas en gran parte de los casos la clave diagnóstica 1,2,6,14,15 . Otras formas de presentación poco frecuentes incluyen insufi ciencia suprarrenal, hipertensión pulmonar, síndrome nefrótico, infarto de miocardio y enfermedad pulmonar intesticial.…”

A 62-Year-Old Man With Fluctuating Neurological Deficits and Skin Lesions

“…1,8,9 Skin biopsy specimens are taken from multiple sites. 1,9 The location of the skin lesions should determine the site of a biopsy. 9 In the Asian cohort study, 1 13 patients without skin manifestations were determined to have tumor cells with skin involvement.…”

Site Selection

“…There are limited data on how often blind skin biopsy specimens yield positive results in intravascular large B-cell lymphoma, and there are no guidelines on which sites to choose or how many biopsies to perform. [30] One way to select the site of biopsy is reviewing the frequency depending on location, a recent review reported: thigh (41%), leg (35%), trunk (31%), arm (15%), and buttock (7,5%). [28] Based on this review, biopsy specimens from the case of Le et al were taken from the front of the thighs bilaterally, with 3 of the 4 revealing intravascular large B-cell lymphoma.…”

“…[28] Based on this review, biopsy specimens from the case of Le et al were taken from the front of the thighs bilaterally, with 3 of the 4 revealing intravascular large B-cell lymphoma. [30] They have done more than one biopsy because of the small size of the biopsy specimen itself. The skin biopsy is a valuable and minimally invasive diagnostic tool that should be considered for patients with a high index of suspicion for intravascular large B-cell lymphoma, even in the abscense of cutaneous findings.…”

“…The skin biopsy is a valuable and minimally invasive diagnostic tool that should be considered for patients with a high index of suspicion for intravascular large B-cell lymphoma, even in the abscense of cutaneous findings. [30] Sjoberg et al described another use of skin biopsy, it can be useful to remove sea urchin spines.…”