Primary Intravascular Large B-cell Lymphoma Research Articles

Primary pulmonary intravascular large B-cell lymphoma: A report of three cases and literature review.

The present study aimed to investigate the clinicopathological features of primary intravascular large B-cell lymphoma (IVLBCL) of the lung. The clinical and histopathological data of three patients, and the literature was reviewed. The Ethics Committees of Drum Tower Hospital approved the current study based on the three cases. Fever and respiratory symptoms were the main presenting symptoms. Serum lactate dehydrogenase and C-reactive protein were significantly increased. Diffuse ground glass opacities or nodular consolidations were seen on high resolution computed tomography. Lung biopsy revealed lymphoma cells in the lumen of small blood vessels. Tumor cells expressed cluster of differentiation 20 and melanoma associated antigen (mutated) 1. Primary pulmonary IVLBCL is extremely rare and its prognosis is poor. Full recognition of its clinical character and improvement of the diagnostic awareness may help to reduce missed diagnosis, and facilitate appropriate treatment.

Primary intravascular large B-Cell lymphoma of the central nervous system - Antemortem diagnosis and review of literature

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma occurring in adults, characterised by growth of neoplastic lymphoid cells within the lumina of blood vessels, particularly capillaries. The clinical presentations are non-specific and histological features are often subtle. We report a case of a 60-year-old male who presented with a several week history of headaches, general malaise and fluctuating visual disturbances followed by sudden onset of confusion. Neurological deficits included disorientation, nominal aphasia, left-right disorientation and left sided homonomous hemianopia. MRI of the brain revealed diffuse leptomeningeal enhancement and digital subtraction angiography showed an abnormality of a branch of the left of middle cerebral artery consistent with CNS vasculopathy. The differential diagnosis included vasculitis, stroke and atypical migraine necessitating an open biopsy. The histological sections revealed an intravascular infiltrate of large neoplastic B-cells that express CD20 within leptomeningeal vessels and small intrapar-encymal vessels with no involvement of the brain parenchyma. The case illustrates the protean clinical manifestations of CNS IVLBCL and the subtleties of its histological diagnosis. Correct diagnosis is important as treatment regimes drastically differ between IVLBCL and its clinical mimics.

Primary Intravascular large B-cell lymphoma of lung: a report of one case and review

ObjectiveTo investigate the clinicopathological features of primary intravascular large B-cell lymphoma of lung.MethodsA case of primary pulmonary intravascular large B-cell lymphoma was analysed in histopathology and immunophenotype.ResultsThe patient is a 42-year-old female who had cough for one year. Computed tomography showed ground-glass opacities and small nodules in bilateral lung fields. Histopathology demonstrated accumulation of similar sized neoplastic cells within alveolar capillaries, widening the alveolar septae. The alveolar structure sustained in part of districtions. Immunohistologically, the tumor cells were positive for CD20 and negative for CD3,CK, which were similar to the diffuse large B-cell lymphoma.ConclusionsIntravascular large B-cell lymphoma is an uncommon type of non-Hodgkin’s lymphoma. Primary pulmonary presentation is even more rare. The diagnosis is based on the histopathology and immunohistochemistry.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2076991810705433.

Primary intravascular large B-cell lymphoma of pituitary

A 68-year-old retired nurse, who was a known hypertensive on medication, presented with prolonged fever of 2-month duration without any clinical evidence of infection. On examination she had altered mental status. She also had other nonspecific complaints such as sleep disturbances, loss of weight, etc. On investigation, she was found to have anemia, thrombocytopenia, raised erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lactate dehydrogenase (LDH) values. She also had electrolyte imbalance. Radiological evaluation of brain showed mass lesion in the sella turcica, suggestive of pituitary adenoma. Biochemical evaluation showed hypopituitarism. Trans-sphenoidal biopsy was done. Based on histopathological and immunohistochemical findings a diagnosis of intravascular large B-cell lymphoma (IVLBCL) of pituitary was made. Our patient's condition deteriorated rapidly and she succumbed to her illness before therapy could be initiated. We are reporting this case because of the rare subtype of large B-cell lymphoma presenting at an extremely unusual primary site.

Prolonged Survival Using Anti-CD20 Combined Chemotherapy in Primary Prostatic Intravascular Large B-cell Lymphoma

Here we report a case of a 73-year-old man with primary intravascular large B-cell lymphoma localized to the prostate. Total prostatectomy was performed due to a benign adenoma suggested by ultrasonography. The diagnosis of IVLBL was obtained incidentally from the prostatectomy specimen. Eight months after the initial R-CHOP chemotherapy a relapse was detected in the left inguinal lymph node, where histologic examination revealed common diffuse large B-cell lymphoma with minimal intravascular component. The second complete remission was achieved by R-IEV therapy. Five months later a second relapse occurred and the patient died in the widespread disease and pneumonia. Primary prostate IVLBL is extremely uncommon; to date only four cases have been described. This is a well documented case, where we also confirmed that the initial primary IVLBL and the secondary lymph node involvement are clonally related. Successful treatment depends on early diagnosis of IVLBL, aggressive chemotherapy and the fact that IVLBL should be considered as a generalized disease in spite of negative staging results.