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Enzan N, Kitadate A, Kono M. Optimizing random skin biopsies: a review of techniques and indications for intravascular large B-cell lymphoma. Int J Hematol 2024; 119:619-625. [PMID: 38564093 PMCID: PMC11136846 DOI: 10.1007/s12185-024-03757-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
Intravascular large B-cell lymphoma (IVLBCL), a rare subtype of malignant lymphoma, is diagnosed by observation of intravascular proliferation of tumor cells in samples taken from affected organs. However, diagnosis of IVLBCL is usually difficult due to the lack of mass formation. IVLBCL may be fatal when the diagnosis is delayed, so an accurate early diagnosis is the key to successful treatment. Random skin biopsy (RSB), in which specimens are sampled from normal-appearing skin, has been reported as useful. However, the specific method of RSB remains controversial, with individual institutions using either the punch method or the incisional method. Research has shown that the incisional method has higher sensitivity than the punch method. We discuss whether this difference might owe to the collection of punch specimens from an insufficient depth and whether the punch method might result in false negatives. For RSB, we recommend taking specimens not only from normal-appearing skin, but also from any lesional skin, because lesions may reflect micro IVLBCL lesions. To ensure accurate diagnosis, both dermatologists and hematologists should know the proper method of RSB. This review summarizes the appropriate biopsy method and sites for RSB.
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Affiliation(s)
- Naoko Enzan
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Akihiro Kitadate
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Michihiro Kono
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
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Serrano AG, Elsner B, Cabral Lorenzo MC, Morales Clavijo FA. Intravascular Large B-Cell Lymphoma and Renal Clear Cell Carcinoma as Collision Tumor: A Case Report and Review of the Literature. Int J Surg Pathol 2020; 29:653-657. [PMID: 33345662 DOI: 10.1177/1066896920981633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma characterized by the selective growth of lymphoma cells within the lumina of vessels. The patient usually presents with nonspecific symptoms and a remarkable deterioration in performance status. The occurrence of synchronous IVLBCL and renal cell carcinoma (RCC) is extremely rare. A right kidney tumor was found in a 72-year-old man with a history of low back pain. The kidney was enlarged, with a tumor mass measuring 4.5 × 4 × 4 cm. Sections exhibited a RCC (clear cell type, nuclear grade I). Also an extensive tumor affecting capillaries and small veins was present, positive for CD45, CD20, BCL-2, and MUM1/IRF-4, consistent with IVLBCL. The lymphoma was circumscribed to the RCC. The final diagnosis was IVLBCL with a RCC as collision tumor. After that, with neurological findings, central nervous system compromise by lymphoma was made. The patient started a first cycle of chemotherapy, progressive deterioration of the sensorium, and positive blood cultures for Klebsiella pneumoniae and Escherichia coli. The patient died 8 days later of acute respiratory failure. No autopsy was done. IVLBCL is an aggressive and systemic disease characterized by massive proliferation of tumor cells without a known primary site. Clinical identification and histopathologic diagnosis are relevant issues in the therapeutic management of these lymphomas. Until now, only one case of IVLBCL coexisting with RCC has been reported. In this article, we report a second case of IVLBCL with RCC simultaneous, as an unusual collision tumor.
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Limited Renal Intravascular Lymphoma: A Case Report and Review of the Literature. Case Rep Oncol Med 2020; 2020:7052536. [PMID: 33083073 PMCID: PMC7563074 DOI: 10.1155/2020/7052536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 08/07/2020] [Accepted: 09/20/2020] [Indexed: 11/17/2022] Open
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma. It is characterized by the proliferation of cancerous cells into the intraluminal space of the blood vessels. It has a low incidence rate of 0.095 cases per 1,000,000. The clinical presentation is insidious and unspecific, often delaying the diagnosis. IVLBCL can be diagnosed through body images and histopathology analysis. This neoplasm averages a 60% response rate to current chemotherapy treatment, favoring rituximab, and doxorubicin-based regimen if it is diagnosed in time. Here, we present the case of a 56-year-old man admitted to our hospital with a fever who was eventually diagnosed with IVLBCL. He presented to the consultation with anemia, fever, and splenomegaly. An infection panel, a bone marrow biopsy, and a PET-CT scan were performed and ruled out the possibility of infections and neoplasms. The patient later developed edematous syndrome. As a result, a renal biopsy was performed which tested positive for intravascular large B-cell lymphoma. Currently, the patient has been in complete remission for 33 months. Along with presenting this specific case, we also reviewed previously published cases of IVLBCL to illustrate the renal involvement of this pathology.
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Margolskee EM, Salvatore SP, Geyer JT. Lymphoid Neoplasms of the Kidney. KIDNEY CANCER 2020. [DOI: 10.1007/978-3-030-28333-9_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Desclaux A, Lazaro E, Pinaquy JB, Yacoub M, Viallard JF. Renal Intravascular Large B-cell Lymphoma: A Case Report and Review of the Literature. Intern Med 2017; 56:827-833. [PMID: 28381751 PMCID: PMC5457928 DOI: 10.2169/internalmedicine.56.6406] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We herein report the case of a 52-year-old woman who consulted us because of a 2-month history of a fever, anorexia and weight loss. A physical examination was unremarkable. The blood count showed mild anemia and lymphopenia, and lactate dehydrogenase was elevated. Creatinine clearance was normal and proteinuria was undetectable. CT showed enlarged kidneys. A bone marrow biopsy was normal. PET-CT showed an intense uptake of 18fluorodeoxyglucose in both kidneys. A kidney biopsy provided the diagnosis of intravascular large B-cell lymphoma (IVLBCL). Kidney-limited IVLBCL without an impairment in the renal function or proteinuria has not been described. We analyzed the 38 published cases of IVLBCL involving the kidney to describe the main features of this entity.
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Affiliation(s)
- Arnaud Desclaux
- Internal Medicine and Infectious Diseases Unit, Haut-Leveque Hospital, France
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6
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Shetty S, Singh AC, Babu V. Primary Renal Lymphoma - A Case Report and Review of Literature. J Clin Diagn Res 2016; 10:XD05-XD07. [PMID: 27790565 PMCID: PMC5072065 DOI: 10.7860/jcdr/2016/20901.8577] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022]
Abstract
Primary Renal Lymphoma (PRL) is rare and its existence has been called into question due to the absence of lymphatic tissue within renal parenchyma. Non-specific abdominal pain with mass in the lumbar region and otherwise unexplained renal failure is the most common presentation. Almost all patients eventually develop extrarenal lymphomatous disease and few patients survive beyond one year. Surgical treatment is rarely feasible as primary modality of treatment since the tumour often encases major vessels and surrounding organs necessitating major resection. Instead, an attempt can be made to downstage the tumour with chemotherapy before attempting surgery. Here we present a case of primary renal Non-Hodgkins Lymphoma (NHL) which was treated with chemotherapy but the patient succumbed to disease before the third cycle.
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Affiliation(s)
- Shraddha Shetty
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Avinash Chandra Singh
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Vinod Babu
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Kaneyuki D, Komeno Y, Yoshimoto H, Yoshimura N, Iihara K, Ryu T. Intestinal Intravascular Large B-cell Lymphoma Mimicking Ulcerative Colitis with Secondary Membranoproliferative Glomerulonephritis. Intern Med 2016; 55:2475-81. [PMID: 27580553 DOI: 10.2169/internalmedicine.55.6737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 47-year-old woman with ulcerative colitis (UC) was admitted to our hospital for renal dysfunction and progressive anemia. Colonoscopy revealed intestinal lesions and pathological findings showed intravascular large B-cell lymphoma (IVLBCL). According to the polymerase chain reaction analysis of sequential rectal specimens, we concluded that she suffered from intestinal BCL, not UC. After chemotherapy, her renal function progressed to nephrotic syndrome. The pathological findings of renal biopsy specimens indicated membranoproliferative glomerulonephritis (MPGN). Chemotherapy was continued and led to the remission of BCL and MPGN. We herein describe the first case of intestinal IVLBCL mimicking UC with secondary MPGN.
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Affiliation(s)
- Daisuke Kaneyuki
- Department of Hematology, Japan Community Healthcare Organization (JCHO) Tokyo Yamate Medical Center, Japan
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Hasegawa J, Hoshino J, Suwabe T, Hayami N, Sumida K, Mise K, Ueno T, Sawa N, Wake A, Ohashi K, Fujii T, Honda K, Takaichi K, Ubara Y. Characteristics of Intravascular Large B-Cell Lymphoma Limited to the Glomerular Capillaries: A Case Report. Case Rep Nephrol Dial 2015; 5:173-9. [PMID: 26351627 PMCID: PMC4555212 DOI: 10.1159/000437296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 65-year-old woman was admitted to our hospital for the evaluation of rapidly progressive renal dysfunction with serum creatinine of 2.7 mg/dl and urinary protein of 1.5 g daily. C-reactive protein (CRP) was 0.1 mg/dl. Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs. Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well. When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.
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Affiliation(s)
- Jumpei Hasegawa
- Nephrology Center, Toranomon Hospital, Tokyo, Japan ; Department of Nephrology, Ohkubo Hospital, Tokyo, Japan
| | | | | | | | | | - Koki Mise
- Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | | | - Naoki Sawa
- Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kenichi Ohashi
- Department of Pathology, Toranomon Hospital, Tokyo, Japan
| | - Takeshi Fujii
- Department of Pathology, Toranomon Hospital, Tokyo, Japan
| | - Kazuho Honda
- Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenmei Takaichi
- Nephrology Center, Toranomon Hospital, Tokyo, Japan ; Department of Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Yoshifumi Ubara
- Nephrology Center, Toranomon Hospital, Tokyo, Japan ; Department of Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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10
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Li SJ, Chen HP, Chen YH, Zhang LH, Tu YM, Liu ZH. Renal involvement in non-Hodgkin lymphoma: proven by renal biopsy. PLoS One 2014; 9:e95190. [PMID: 24733356 PMCID: PMC3986362 DOI: 10.1371/journal.pone.0095190] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 03/24/2014] [Indexed: 11/18/2022] Open
Abstract
Aims To determine the spectrum of renal lesions in patients with kidney involvement in non-Hodgkin's lymphoma (NHL) by renal biopsy. Methods The clinical features and histological findings at the time of the renal biopsy were assessed for each patient. Results We identified 20 patients with NHL and renal involvement, and the diagnosis of NHL was established following the kidney biopsy in 18 (90%) patients. The types of NHL include the following: chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 8), diffuse large B-cell lymphoma (n = 4), T/NK cell lymphoma (n = 3), lymphoplasmacytic lymphoma (n = 2), cutaneous T-cell lymphoma (n = 1), mucosa-associated lymphoid tissue lymphoma (n = 1) and mantle cell lymphoma (n = 1). All presented with proteinuria, and 15 patients had impaired renal function. The pathological findings included (1) membranoproliferative glomerulonephritis-like pattern in seven patients; (2) crescent glomerulonephritis in four; (3) minimal-change disease in three, and glomeruli without specific pathological abnormalities in three; (4) intraglomerular large B-cell lymphoma in one; (5) intracapillary monoclonal IgM deposits in one; (6) primary diffuse large B-cell lymphoma of the kidneys in one; and (7) lymphoma infiltration of the kidney in eight patients. Conclusion A wide spectrum of renal lesions can be observed in patients with NHL, and NHL may be first proven by renal biopsies for evaluation of kidney injury or proteinuria. Renal biopsy is necessary to establish the underlying cause of renal involvement in NHL.
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Affiliation(s)
- Shi-Jun Li
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
| | - Hui-Ping Chen
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
| | - Ying-Hua Chen
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
| | - Li-hua Zhang
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
| | - Yuan-Mao Tu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
| | - Zhi-hong Liu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University of Medcine, Nanjing, China
- * E-mail: zhihong—
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11
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Kamalanathan M, Wright D, Johnston R, Webb A, Kingdon E. Intravascular large B-cell lymphoma diagnosed at renal biopsy. Clin Kidney J 2012; 6:100-101. [PMID: 27818763 PMCID: PMC5094391 DOI: 10.1093/ckj/sfs159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 10/09/2012] [Indexed: 12/03/2022] Open
Affiliation(s)
| | - David Wright
- Department of Histopathology, Royal Sussex County Hospital, Brighton, Sussex, UK
| | - Rosalynd Johnston
- Department of Haematology, Royal Sussex County Hospital, Brighton, Sussex, UK
| | - Andrew Webb
- Department of Oncology, Royal Sussex County Hospital, Brighton, Sussex, UK
| | - Edward Kingdon
- Sussex Kidney Unit , Royal Sussex County Hospital , Brighton , Sussex , UK
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12
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Primary renal lymphoma: long-term results of two patients treated with a chemotherapy + rituximab protocol. Case Rep Oncol Med 2012; 2012:726424. [PMID: 22997596 PMCID: PMC3446643 DOI: 10.1155/2012/726424] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 08/22/2012] [Indexed: 11/18/2022] Open
Abstract
Primary renal lymphoma (PRL) is a rare disease of which the etiology and pathogenesis remain controversial, and there is currently no standard treatment for it. We present the results of a long-term followup of two patients who were diagnosed with PRL and treated with cyclophosphamide, adriamycin, vincristine, prednisolone and rituximab (CHOP + R) regimen. Both patients reached a complete response, and there is no evidence of recurrence after 4.5- and 5-year followup periods. Based on our experience and other recently published studies, we recommend the combination of CHOP + rituximab as the elective treatment for this disease. To our knowledge, this is the longest followup period with a complete response that has been reported with this modality of treatment.
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Shirai S, Takahashi I, Kanoh T, Sato K, Kubota KC, Yabe I, Murayama S, Sasaki H. [Case of intravascular lymphoma with a longitudinal spinal lesion diagnosed by multiple biopsies]. Rinsho Shinkeigaku 2012; 52:336-43. [PMID: 22688113 DOI: 10.5692/clinicalneurol.52.336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 45-year-old man was admitted to our hospital with flaccid paraplegia. Neurological examination at a local hospital, 2 months before admission to our hospital, showed sensory impairment of the right posterior surface of the thigh and a decreased Achilles tendon reflex. Spinal magnetic resonance imaging (MRI) showed a T₂ weighted high-intensity area at the Th10-11 level that was more pronounced in the gray matter. The patient developed flaccid paraparesis and urinary retention. No improvement was observed after 2 rounds of methylprednisolone (mPSL) pulse therapy. Spinal cord biopsy showed demyelinated axons and myelinophagia without any tumorous lesion. Myelopathy exacerbated, and hence, plasma exchange was performed. However, this was ineffective. We suspected that myelopathy was caused by intravascular lymphoma (IVL) because of the presence of a low-grade fever, weight loss, and elevated serum soluble IL-2 receptor titers. Random biopsies, including skin, rectal, bone marrow, muscle, and renal biopsies, and splenectomy were performed to make a definite diagnosis of IVL myelopathy. Among these biopsies, the diagnosis of IVL myelopathy was confirmed from the renal specimen. The patient underwent chemotherapy at our hospital, and the IVL remitted. The results of this study confirm that sufficient systemic investigation by using tissue biopsy specimens should be performed in order to confirm the diagnosis of IVL myelopathy.
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Affiliation(s)
- Shinichi Shirai
- Department of Neurology, Hokkaido University Graduate School of Medicine
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True identity of endocapillary proliferation: a case of intravascular large B cell lymphoma diagnosed with immunohistochemical study of kidney biopsy and literature review. CEN Case Rep 2012; 1:61-68. [PMID: 28509062 DOI: 10.1007/s13730-012-0014-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 04/10/2012] [Indexed: 12/20/2022] Open
Abstract
A 78-year-old Japanese female presented with low-grade fever, malaise, and appetite loss lasting for 1 month. Upper and lower gastrointestinal endoscopy and contrast-enhanced whole-body computed tomography (CT) revealed no abnormal findings at a referring hospital. She was referred to our hospital because of bilateral leg edema and 2.5 g/day proteinuria. Serum creatinine was 0.73 mg/dl and the kidneys were not enlarged. Kidney biopsy showed marked endocapillary proliferation with mesangiolysis. Soon after the kidney biopsy, her symptoms improved spontaneously, along with decreases in lactate dehydrogenase (LDH) from 503 to 197 IU/l, C-reactive protein (CRP) from 4.47 to 0.66 mg/dl, and soluble interleukin-2 receptor (sIL-2R) from 1789 to 1001 U/ml. Thus, she was followed carefully as an outpatient. One month later, however, she presented with dysarthria and right-sided hemiparesis, and diffusion-weighted brain magnetic resonance imaging (MRI) showed multiple high-intensity areas. She also had respiratory failure, and lung perfusion scintigraphy showed multiple low blood stream areas. Suspecting some endovascular abnormality, we performed immunohistochemical staining of the kidney biopsy specimen taken previously to find that endocapillary infiltrating cells were CD20-positive B lymphocytes. The infiltrating cells were confined to the endocapillary compartment in glomeruli and peritubular capillaries. Both clinical and pathological findings led us to diagnose intravascular large B cell lymphoma (IVLBCL). Two bone marrow biopsies and random skin biopsies were performed, but no abnormality was found. The present case demonstrates that clinical course and renal biopsy findings of intravascular large B cell lymphoma may mimic other renal conditions and that the identification of cell types with immunohistochemical staining may help establish an accurate diagnosis.
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Intravascular large B-cell lymphoma of the kidney: a case report. Diagn Pathol 2011; 6:86. [PMID: 21943175 PMCID: PMC3189105 DOI: 10.1186/1746-1596-6-86] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 09/23/2011] [Indexed: 11/13/2022] Open
Abstract
We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months. She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L), serum albumin of 2.89 g/dL (28.9 g/L), urea nitrogen of 2.24 mg/dL (1.6 mmol/L), and serum creatinine of 0.54 mg/dL (48 μmol/L). Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT) showed marked bilateral swelling and enlargement of the renal parenchyma with splenic enlargement and involvement of multiple vertebrae. Percutaneous renal biopsy showed island-like accumulations of medium to large lymphoid cells in many areas of the interstitium, with round vesicular nuclei containing distinct basophilic nucleoli. Immunohistochemical analysis together with other supportive investigation confirmed the diagnosis of intravascular large B-cell lymphoma. Ten days later, she was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, leurocristime and prednisone) for a week. Palliative radiotherapy DT 40Gy/20F with other supportive treatment was provided for metastatic foci in the medullary cavity of the sternum, T1-T7. The patient regained muscle strength in both lower limbs and was able to walk again after three weeks. The patient was discharged after hepatic and renal function and proteinuria values had returned to normal. Follow-up data shows the patient to be alive nine months after discharge.
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16
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Xu M, Yang Q, Li M, Geng W, Huang W, Chen Y. Prostate Involvement by Intravascular Large B-Cell Lymphoma. Int J Surg Pathol 2011; 19:544-7. [PMID: 21632638 DOI: 10.1177/1066896911408721] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prostate involvement by intravascular large B-cell lymphoma (IVLBL) is extremely rare. Until now, only 6 cases have been reported in the literature. In this article, the authors report a case of a 65-year-old Chinese man with IVLBL located in the prostate. The diagnosis of IVLBL was obtained incidentally from a biopsy of his prostatectomy specimen. The patient underwent CHOP therapy for 5 cycles and had a favorable clinical outcome.
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Affiliation(s)
- Man Xu
- Chongqing Medical University, Chongqing, China
| | | | - Mingxu Li
- Changshou People’s Hospital, Chongqing, China
| | - Weipu Geng
- Chongqing Medical University, Chongqing, China
| | | | - Yu Chen
- Chongqing Medical University, Chongqing, China
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Yap DYH, Leung CCH, Hwang GYY, Leung AYH, Chan GSW, Chan KW, Tang SCW. Pyrexia of unknown origin and proteinuria: an enigma solved by renal biopsy. Nephrology (Carlton) 2011; 16:249-50. [PMID: 21272140 DOI: 10.1111/j.1440-1797.2010.01388.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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