A Case of Intravascular Diffuse Large B-Cell Lymphoma Initially Suspected as Interstitial Pneumonia Associated With Systemic Scleroderma.

Shigemichi Hirose,Yumi Tsuchiya,Kota Ishioka,Morio Nakamura,Hisako Kunieda,Reishi Seki,Tomoyo Oguri,Saeko Takahashi,Shinji Sasada,Yoshifumi Kimura,Yuki Aramaki-Sumii

doi:10.1177/2324709621999226

Abstract

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse LBCL. The patient was a 71-year-old female admitted to our hospital with hypoxia. On admission, chest computed tomography revealed a ground-glass opacity. Interstitial pneumonia associated with systemic scleroderma was suspected because of positive anti-centromere antibody. Thereafter, steroid pulse therapy and plasma exchange were performed. Although ground-glass opacity improved, bilateral pleural effusion appeared, so we performed a random skin biopsy because of her elevated serum lactate dehydrogenase and soluble interleukin-2 receptor levels. The patient was diagnosed with IVLBCL with symptoms improving after 6 cycles of rituximab plus chemotherapy treatment.

Highlights

The World Health Organization classification defines intravascular diffuse large B-cell lymphoma (IVLBCL) as a rare subtype of non-Hodgkin’s lymphoma, where neoplastic cells grow mainly in the lumina of small vessels.[1]
We report an IVLBCL case with ground-glass opacity (GGO) of the bilateral lungs and anti-centromere antibody positivity in blood tests, which required distinction from interstitial pneumonia related to collagen disease
Our IVLBCL case needed to be differentiated from interstitial pneumonia related to systemic scleroderma with positive anti-centromere antibody because their clinical courses are quite similar and due to some reports on malignant lymphoma associated autoimmune disease.[6]

Summary

Introduction

The World Health Organization classification defines intravascular diffuse large B-cell lymphoma (IVLBCL) as a rare subtype of non-Hodgkin’s lymphoma, where neoplastic cells grow mainly in the lumina of small vessels.[1]. We report an IVLBCL case with ground-glass opacity (GGO) of the bilateral lungs and anti-centromere antibody positivity in blood tests, which required distinction from interstitial pneumonia related to collagen disease.

Results

Conclusion