Two Cases of Intravascular Lymphoma Diagnosed by Gastrointestinal Endoscopic Biopsy

Sugiyama, Yasuyuki; Sugimoto, Kensuke; Kotake, Mie; Uehara, Daisuke; Kamide, Yosuke; Kuribayashi, Shiko; Kawamura, Osamu; Kusano, Motoyasu; Handa, Hiroshi; Hirato, Junko; Yamada, Masanobu

doi:10.2169/internalmedicine.54.4764

Cited by 6 publications

(8 citation statements)

References 12 publications

(11 reference statements)

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“…Although Ponzoni et al stated that IVLBCL may be detected in the lamina propria of the gastrointestinal tract [10], very few cases of IVLBCL have been reported in the small intestine [11,12]. Based on limited microscopic photographs [12], we still found very different morphologies between IVLBCL and intralymphatic spread (Fig.…”

Section: Discussionmentioning

confidence: 66%

Mucosal intralymphatic spread in a relapsed diffuse large B cell lymphoma

Yuan

2020

J Hematopathol

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Intralymphatic spread is a rare finding and is associated with poor prognosis in diffuse large B cell lymphoma (DLBCL). Here, we report a case of relapsed DLBCL with mucosal intralymphatic spread. A 69-year-old man had been diagnosed with gastric DLBCL stage IIE at 57 years. He had a relapse with generalized lymphadenopathy and extranodal involvement at 61 years; then, second complete remission was achieved after salvage chemotherapy. He then had a second relapse with involvement of the terminal ileum, spinal cord, and left tonsil. The terminal ileum showed intralymphatic spread in the lamina propria of the intestinal villi, which was confirmed by D2-40 immunostaining. Eleven months later, another biopsy showed prominent intralymphatic spread in the mucosa of the terminal ileum. After salvage therapies, the spinal cord and tonsillar tumors resolved, but the intestinal tumors were refractory. The patient eventually died of progressive disease. In contrast to previously reported cases, the involved lymphatic vessels were observed in the mucosa, and the lymphoma cells expressed CD5 in the first colonoscopic biopsy. This rare case broadens the spectrum of intralymphatic spread in DLBCL.

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Section: Discussionmentioning

confidence: 66%

Mucosal intralymphatic spread in a relapsed diffuse large B cell lymphoma

Yuan

2020

J Hematopathol

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“…11 In the case reports, most of the lymphoma with FUO is various T-NHL, while some rare types of B-NHL could be found, such as intravascular diffuse large B-cell lymphoma. [12][13][14] In our study, the major proportion of lymphoma with the FUO was also B-NHL (48.9%).…”

Section: Discussionmentioning

confidence: 80%

Clinical Features and Long-term Outcomes of Lymphoma Patients Initially Presenting as Fever With Unknown Origin

Wulipan

et al. 2021

Preprint

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BackgroundLymphoma is found to be the main source of non-infectious fever of unknown origin (FUO). However, there is a lack of clinical features and outcomes in lymphoma patients initially presenting as FUO.MethodsFrom January 1, 2013 to December 31, 2019, our center enrolled 185 patients who initially presented as FUO then confirmed to be lymphoma in Huadong Hospital of Fudan University. During the same study period, 332 lymphoma patients without FUO received treatment in our center. After the exclusion, 509 patients were included in the retrospectively study. The differences in clinical manifestations, laboratory examinations, overall response rates and survival rates between the FUO and non-FUO groups were analyzed. The clinical endpoints were overall survival (OS) and progress-free survival (PFS).ResultsIn the non-FUO group (329 in total), Hodgkin’s lymphoma (HL) was 17 (5.2%), B cell non-Hodgkin’s lymphoma (B-NHL) was 276 (83.9%), T cell non-Hodgkin’s lymphoma (T-NHL) was 32 (9.7%) and NK/T cell lymphoma (NK/T-CL) was 4 (1.2%). In the FUO group (180 in total), B-NHL was 88 (48.9%), T-NHL was 60 (33.3%), NK/T-CL was 24 (13.3%) and HL was 8 (4.4%). During the hospitalization, the maximum body temperature of the FUO group diagnosed with B-NHL, T-NHL and NK/T-CL was statistically higher than that of the non-FUO group (all P<0.05). Concerning the overall response rates, there was no difference between the FUO and non-FUO groups, whatever the pathological subtype was. The differences in OS between the FUO and non-FUO groups were significant for HL (P=0.006), B-NHL (P=0.007) and T-NHL (P=0.013). No difference in overall survival was observed in the two groups for the subtype of NK/T-CL (P=0.141). In terms of PFS, there was no significant difference between FUO and non-FUO groups for any subtype (all P>0.05).ConclusionWe found that the major subtypes of lymphoma initially presenting as FUO were B-NHL and T-NHL. The main diagnostic biopsy sites were subcutaneous lymphnodes, bone marrow and spleen for lymphoma patients with FUO. Patients with FUO suffered from a higher risk of all-cause death in the long term.

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“…10 According to the literature we collected, there are 12 reports of IVLBCL occurring in the gastrointestinal system, involving 15 cases, of which 5 occurred in the small intestine. 10,[22][23][24][25][26][27][28][29][30][31][32] The clinicopathological characteristics of IVLBCL in the gastrointestinal tract are described in Supplemental Table 1. The pathogenesis of IVLBCL in the gastrointestinal tract is complex, and the clinical symptoms almost always present as acute abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers have performed multisite biopsies on patients with IVLBCL of the gastrointestinal tract, and their findings indicate that patients with gastrointestinal symptoms as the initial symptom may have systemic involvement; therefore, early diagnosis is especially important for these patients. 30 There have been 3 cases of EBV-positive IVLBCL reported in the literature. [33][34][35] One case (1 of 3) was associated with HIV infection, while the other 2 cases (2 of 3) involved elderly adults without EBV infection or acquired immunodeficiency syndrome (AIDS).…”

Section: Discussionmentioning

confidence: 99%

EBV-Positive Intravascular Large B-Cell Lymphoma of the Small Intestine: A Case Report and Literature Review

Pan

Yao

et al. 2023

Int J Surg Pathol

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Intravascular large B-cell lymphoma (IVLBCL) is a rare lymphoma that affects the brain, skin, and bone marrow. We describe the case of a 75-year-old man who was admitted to the hospital after 4 h of stomach aches. A thorough physical examination indicated stomach discomfort and skin discoloration. Laboratory tests revealed thrombocytopenia and elevated lactate dehydrogenase levels. A computed tomography scan of the abdomen revealed that the small intestine wall was thickened, edematous, and necrotic. The necrotic small bowel was surgically removed, revealing many little round, homogenous, and unusual cells in the mesenteric vein. In-situ hybridization revealed that these cells were positive for PAX5, CD20, CD79a, CD10, and BCL2, as well as Epstein-Barr virus-encoded small RNA. After 1 week of hospitalization without treatment, the patient was diagnosed with IVLBCL and died of multiple organ dysfunction syndrome. IVLBCL is a rare illness that affects the small intestine and possibly the gastrointestinal system. It has an insidious start, a fast development, and a dismal prognosis. Knowing its clinicopathologic traits helps in understanding the illness, making an early diagnosis, and preventing rapid worsening.

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Two Cases of Intravascular Lymphoma Diagnosed by Gastrointestinal Endoscopic Biopsy

Cited by 6 publications

References 12 publications

Mucosal intralymphatic spread in a relapsed diffuse large B cell lymphoma

Mucosal intralymphatic spread in a relapsed diffuse large B cell lymphoma

Clinical Features and Long-term Outcomes of Lymphoma Patients Initially Presenting as Fever With Unknown Origin

EBV-Positive Intravascular Large B-Cell Lymphoma of the Small Intestine: A Case Report and Literature Review

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