Intravascular large B-cell lymphoma presenting as panniculitis clinically: a case report

A case of Intravascular Lymphoma Masquerading as Calciphylaxis in a Patient on Haemodialysis

Intravascular large B-cell lymphoma (IVLBCL) is a rare lymphoma entity with intravascular proliferation of clonal lymphocytes restricted to the lumen of small- and medium-sized blood vessels. In this case report, we describe a 70-year-old lady on maintenance hemodialysis who presented with altered sensorium and painful lesions over her inner thigh. While preliminary investigations were favoring calciphylaxis, it was the skin biopsy that showed vasculopathic lymphoid infiltrate with focal panniculitis, consistent with intravascular lymphoma. Although overall survival is poor, prompt use of intensive therapies have shown to improve the outcome.

Intravascular Large B-cell Lymphoma: A Report of Two Cases

One of the rare variants of extranodal large B-cell lymphoma is intravascular large B-cell lymphoma (IVLBCL). Characteristics of IVLBCL include intraluminal selective proliferation of atypical lymphoid cells in small to medium-sized vessels. The etiologic of IVLBCL is unknown, but due to the growth pattern of this tumor, it is speculated that IVLBCL is caused by a defect in homing receptor of tumor cells. IVLBCL can involve any organ but central nervous system, lungs, and skin are the most involved sites. IVLBCL does not usually involve lymph nodes. IVLBCL mainly occurs in the middle aged to elderly population with a slight male predominance. Generally, IVLBCL is aggressive and rapidly fatal if left untreated.

We here reported two cases of IVLBCL who succumbed to the disease at initial phase of treatment to emphasize the difficulty in diagnosis of IVLBCL due to its exclusive intravascular growth pattern and fulminant clinical course.