Early Diagnosis of Intravascular Large B-Cell Lymphoma by Random Skin Biopsy
  • Kota Sakaguchi
    General Medicine Center, Shimane University Hospital, Shimane, Japan
  • Takashi Watari
    General Medicine Center, Shimane University Hospital, Shimane, Japan; Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA

Keywords

Intravascular large B-cell lymphoma, random skin biopsy, early diagnosis

Abstract

Introduction: Delayed diagnosis of intravascular large B-cell lymphoma (IVLBCL) is associated with a poor prognosis, making early diagnosis and treatment essential. However, early diagnosis remains challenging. 

Case description: Here we present the case of a 75-year-old man with fever of unknown origin, in whom random skin biopsy (RSB) allowed early diagnosis of IVLBCL.

Discussion: The usefulness of RSB, which involves incisional skin biopsies of three or more sites that contain subcutaneous fatty tissue, such as the thighs, abdomen and upper arms, has been debated. In cases of suspected IVLBCL, RSB is less invasive than a biopsy of the internal organs. 

Conclusion: We suggest that combining RSB with bone marrow examination may facilitate the diagnosis of IVLBCL.

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References

  • Shimada K, Matsue K, Yamamoto K, Murase T, Ichikawa N, Okamoto M, et al. Retrospective analysis of intravascular large B-cell lymphoma treated with rituximab-containing chemotherapy as reported by the IVL study group in Japan. J Clin Oncol 2008;26:3189–195. doi: 10.1200/JCO.2007.15.4278.
  • Matsue K, Abe Y, Kitadate A, Miura D, Narita K, Kobayashi H, et al. Sensitivity and specificity of incisional random skin biopsy for diagnosis of intravascular large B-cell lymphoma. Blood 2019;133:1257–1259. doi: 10.1182/blood-2018-11-887570.
  • Fonkem E, Lok E, Robison D, Gautam S, Wong ET. The natural history of intravascular lymphomatosis. Cancer Med 2014;3:1010–1024. doi: 10.1002/cam4.269.
  • Fonkem E, Dayawansa S, Stroberg E, Lok E, Bricker PC, Kirmani B, et al. Neurological presentations of intravascular lymphoma (IVL): meta-analysis of 654 patients. BMC Neurol 2016;16:9. doi: 10.1186/s12883-015-0509-8.
  • Ferreri AJ, Dognini GP, Campo E, Willemze R, Seymour JF, Bairey O, et al.; International Extranodal Lymphoma Study Group (IELSG). Variations in clinical presentation, frequency of hemophagocytosis and clinical behavior of intravascular lymphoma diagnosed in different geographical regions. Haematologica 2007;92:486–492. doi: 10.3324/haematol.10829.
  • Sitthinamsuwan P, Chinthammitr Y, Pattanaprichakul P, Sukpanichnant S. Random skin biopsy in the diagnosis of intravascular lymphoma. J Cutan Pathol 2017;44:729–733. doi: 10.1111/cup.12984.
  • Sakurai T, Wakida K, Takahashi T, Ishida K, Iwata H, Nishida H. Usefulness of senile hemangioma biopsy for diagnosis of intravascular large B-cell lymphoma: a report of two cases and a literature review. J Neurol Sci 2017;373:52–54. doi: 10.1016/j.jns.2016.12.026.
  • Pongpudpunth M, Rattanakaemakorn P, Fleischer AB Jr. Usefulness of random skin biopsy as a diagnostic tool of intravascular lymphoma presenting with fever of unknown origin. Am J Dermatopathol 2015;37:686–690. doi: 10.1097/DAD.0000000000000321.
  • Enzan N, Kitadate A, Tanaka A, Matsue K. Incisional random skin biopsy, not punch biopsy, is an appropriate method for diagnosis of intravascular large B-cell lymphoma: a clinicopathological study of 25 patients. Br J Dermatol 2019;181:200–201. doi: 10.1111/bjd.17603.
  • Maekawa T, Komine M, Murata S, Fukushima N, Ohtsuki M. Random skin biopsy of patients with intravascular large B-cell lymphoma associated with thrombocytopenia and coagulation abnormalities: proposal of a modified biopsy method. J Dermatol 2015;42:318–321. doi: 10.1111/1346-8138.12756.
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    Published: 2022-07-26
    Issue: 2022: Vol 9 No 7 (view)


    How to cite:
    1.
    Sakaguchi K, Watari T. Early Diagnosis of Intravascular Large B-Cell Lymphoma by Random Skin Biopsy. EJCRIM 2022;9 doi:10.12890/2022_003497.