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Knauft J, Schenk T, Ernst T, Schnetzke U, Hochhaus A, La Rosée P, Birndt S. Lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH): a scoping review unveils clinical and diagnostic patterns of a lymphoma subgroup with poor prognosis. Leukemia 2024; 38:235-249. [PMID: 38238443 PMCID: PMC10844097 DOI: 10.1038/s41375-024-02135-8] [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: 11/03/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome driven by pathologic activation of cytotoxic T-lymphocytes and macrophages. Despite advances in diagnostics and management, adult patients with lymphoma-associated HLH (LA-HLH) harbor particularly poor prognosis and optimal treatment remains challenging. As systematic data on LA-HLH are scarce, we aimed to synthesize research evidence by thorough analysis of the published literature in PubMed (MEDLINE-database) within the context of a scoping review. Of 595 search results, 132 articles providing information on 542 patients were reviewed and analyzed. Median patient age was 60 years (range, 18-98) with male predominance (62.7%). B- and T-NHL were equally represented (45.6% and 45.2%), Hodgkin's lymphoma was reported in 8.9% of the cases. The majority of patients (91.6%) presented in Ann-Arbor-Stages III and IV, and bone marrow infiltration was observed in a significant proportion of patients (61.5%). Soluble CD25 levels were markedly elevated (median 10,000 U/ml), with levels beyond 10,000 U/ml indicating unfavorable prognosis for 30-day and overall survival. 66.8% of the patients died after median 5.1 months. LA-HLH remains a clinical challenge requiring specialized management. Timely diagnosis and appropriate lymphoma-specific treatment are of utmost importance to enhance patient outcomes.
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Affiliation(s)
- Johanna Knauft
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Thomas Schenk
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Thomas Ernst
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Ulf Schnetzke
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Paul La Rosée
- Klinik für Innere Medizin II, Onkologie, Hämatologie, Immunologie, Infektiologie und Palliativmedizin, Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
| | - Sebastian Birndt
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.
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Ong YC, Kao HW, Chuang WY, Hung YS, Lin TL, Chang H, Kuo MC. Intravascular Large B-cell lymphoma: A case series and review of literatures. Biomed J 2020; 44:479-488. [PMID: 32344119 PMCID: PMC8514799 DOI: 10.1016/j.bj.2020.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/04/2019] [Accepted: 04/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma with uncommon clinical presentations and poor prognosis. The purpose of this study is to report the clinical features and outcome of IVLBCL in a single institution of Taiwan. Methods Ten patients with IVLBCL diagnosed from June 2006 to January 2018 were retrospectively reviewed. Results The median age was 61 (range 39–88) years. The most common presentation was fever (90%), cytopenia (90%), and confusion (50%). For all patients, the median progression free survival (PFS) and overall survival (OS) were 12.6 (95% confidence interval [CI] 0.0–76.1) and 18.8 (95% CI 0–59.3) months, respectively. Six patients received rituximab combined chemotherapy, and the other one patient was treated with chemotherapy alone. Six of seven (85.7%) patients achieved complete response after chemotherapy. The median PFS and OS for six patients who completed treatment were not reached. Three-year PFS and OS rates were 80% and 75%, respectively. Conclusion Our study showed that patients might achieve durable remission after rituximab-based chemotherapy. The outcome of IVLBCL patients may further improve if early diagnosis and prompt treatment were made.
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Affiliation(s)
- Yuen-Chin Ong
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Hsiao-Wen Kao
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Wen-Yu Chuang
- School of Medicine, Chang Gung University, Taiwan; Division of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Yu-Shin Hung
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Medicine, Chang Gung University, Taiwan
| | - Tung-Liang Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Hung Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; Center of Hemophilia and Coagulation Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Ming-Chung Kuo
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Medicine, Chang Gung University, Taiwan.
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Linnik Y, Nicka C, Lansigan F, Loo E, Liu X. Intravascular Large B-Cell Lymphoma Within a Thyroid Nodule: A Diagnostic Pitfall. Int J Surg Pathol 2018; 26:428-431. [DOI: 10.1177/1066896918763282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a subtype of diffuse large B-cell lymphoma, where the neoplastic lymphoid proliferation resides predominantly within the lumens of blood vessels but with no or few circulating neoplastic cells in the peripheral circulation. Focal or subtle involvement in some cases can cause the diagnosis to be misinterpreted or even overlooked, delaying the initiation of appropriate treatment. Our report focuses on a 78-year-old woman with a progressively enlarging thyroid mass, verified by ultrasound. She underwent a hemithyroidectomy, and microscopic evaluation demonstrated nodular thyroid parenchyma with atypical large cells in an intravascular distribution pattern identified on high magnification. Thorough evaluation showed that the large intravascular cells were positive CD20, PAX-5, and Ki-67 by immunoperoxidase staining, which lead to the diagnosis of IVLBCL. This case emphasizes the subtle appearance of IVLBCL, which may be missed on low-power light microscopy, and the need for careful evaluation of thyroid resection specimens.
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Affiliation(s)
| | | | | | - Eric Loo
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Xiaoying Liu
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Luo B, Chen JM, Liu J, Li WH, Shi YX, Zeng P, Xie YH, Zhang HF. A case of intravascular large B cell lymphoma presenting as nodular goiter. Diagn Pathol 2017; 12:64. [PMID: 28841887 PMCID: PMC5574147 DOI: 10.1186/s13000-017-0656-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intravascular large B-cell lymphoma (IVLBCL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that is rare and highly aggressive and that may progressively involve many organs. CNS (central nervous system), BM (bone marrow) and skin are the most common systems involved. To date, only 2 cases of IVLBCL involving the thyroid have been reported. CASE PRESENTATION Here, we report a case of IVLBCL involving the thyroid and accompanied by bilateral nodular goiter. In this case, a thyroid mass was identified in a physical examination of a 68-year-old male who initially presented with dyspnea accompanied by intermittent headache for approximately 1 month. Computed tomography scans revealed that the left lobar thyroid was occupied by a large, slightly lower density mass (5.8 × 4.7 × 8.4 cm). However, the patient had no hyperthyroidism or hoarseness. Levels of thyroid hormones and anti-thyroid autoantibodies in the serum were normal preoperatively. Thyroid mass resection was performed to establish a diagnosis and to relieve symptoms. CONCLUSIONS Pathological results of the surgical specimen revealed that large atypical lymphoma cells filled the capillaries in the lesion area. Immunohistochemical staining revealed that the large-sized tumor cells were positive for CD20, PAX-5, MUM-1 and BCL-2, and were negative for CD3, CD5, CD43, CD10, CD23, CyclinD1, CD138, CD30, ALK, CD56, MPO, S-100, TTF-1, TG (thyroglobulin) and CT (calcitonin). The Ki-67 index was estimated to be approximately 85%. The patient was subsequently diagnosed as "Classical" IVLBCL non-germinal center B-cell type. The patient declined chemotherapy and died in the fifth month after operation.
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Affiliation(s)
- Bo Luo
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China.
| | - Jia-Mei Chen
- Center of Oncology, Renmin Hospital of Wuhan University, No.99, Zhangzhidong Road, Wuhan City, Hubei Province, 430060, People's Republic of China
| | - Jie Liu
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
| | - Wen-He Li
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
| | - Yu-Xiang Shi
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
| | - Pan Zeng
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
| | - Yong-Hui Xie
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
| | - Hong-Feng Zhang
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Wuhan City, Hubei Province, 430014, People's Republic of China
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Ingle SB, Hinge (Ingle) CR. Primary splenic lymphoma: Current diagnostic trends. World J Clin Cases 2016; 4:385-389. [PMID: 28035311 PMCID: PMC5156875 DOI: 10.12998/wjcc.v4.i12.385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 10/24/2016] [Indexed: 02/05/2023] Open
Abstract
The primary splenic lymphoma is extremely uncommon, can present with grave complications like hypersplenism and splenic rupture. In view of vague clinical presentation, it is difficult to arrive at the diagnosis. In such circumstances, histopathological diagnosis is very important. A precise diagnosis can only be made on histopathology and confirmed on immunohistochemistry.Emergency splenectomy is preferred as an effective therapeutic and diagnostic tool in cases with giant splenomegaly. Core biopsy is usually not advised due to a high risk of post-core biopsy complications in view of its high vascularity and fragility. Aim behind highlighting the topic is to specify that core biopsy/ fine needle aspiration cytology can be used as an effective diagnostic tool to arrive at correct diagnosis to prevent untoward complications related to disease and treatment. Anticoagulation therapy is vital after splenectomy to avoid portal splenic vein thrombosis.
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Usefulness of Random Skin Biopsy as a Diagnostic Tool of Intravascular Lymphoma Presenting With Fever of Unknown Origin. Am J Dermatopathol 2015; 37:686-90. [DOI: 10.1097/dad.0000000000000321] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ingle SB, Ingle CRH. Splenic lymphoma with massive splenomegaly: Case report with review of literature. World J Clin Cases 2014; 2:478-81. [PMID: 25232555 PMCID: PMC4163774 DOI: 10.12998/wjcc.v2.i9478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/10/2014] [Accepted: 06/27/2014] [Indexed: 02/05/2023] Open
Abstract
As per strict criteria of Das Gupta et al, primary splenic lymphoma is very rare. Herein, we are reporting an unusual case of primary large cell splenic lymphoma of B lineage in a middle aged female presenting with massive splenomegaly (3.8 kg) and hypersplenism. After performing therapeutic splenectomy for hypersplenism, a precise diagnosis of diffuse large B cell lymphoma was made on histopathology and confirmed by immunohistochemistry. The patient responded well to standard (Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), Prednisone or prednisolone) regimen last year and is now in full remission. The splenectomy thereby has prevented the potential grave complications related to hypersplenism and splenic rupture. Our aim behind highlighting the topic is to specify that emergency splenectomy followed by anticoagulation therapy is an effective plan of management to prevent untoward complications related to disease and treatment.
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Affiliation(s)
- Sachin B Ingle
- Sachin B Ingle, Department of Pathology, MIMSR Medical College, Latur, Maharashtra 4132512, India
| | - Chitra R Hinge Ingle
- Sachin B Ingle, Department of Pathology, MIMSR Medical College, Latur, Maharashtra 4132512, India
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Ingle SB, Ingle CRH. Splenic lymphoma with massive splenomegaly: Case report with review of literature. World J Clin Cases 2014; 2:478-481. [DOI: 10.12998/wjcc.v2.i9.478] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 06/27/2014] [Indexed: 02/05/2023] Open
Abstract
As per strict criteria of Das Gupta et al, primary splenic lymphoma is very rare. Herein, we are reporting an unusual case of primary large cell splenic lymphoma of B lineage in a middle aged female presenting with massive splenomegaly (3.8 kg) and hypersplenism. After performing therapeutic splenectomy for hypersplenism, a precise diagnosis of diffuse large B cell lymphoma was made on histopathology and confirmed by immunohistochemistry. The patient responded well to standard (Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), Prednisone or prednisolone) regimen last year and is now in full remission. The splenectomy thereby has prevented the potential grave complications related to hypersplenism and splenic rupture. Our aim behind highlighting the topic is to specify that emergency splenectomy followed by anticoagulation therapy is an effective plan of management to prevent untoward complications related to disease and treatment.
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Arima H, Inoue D, Tabata S, Matsushita A, Imai Y, Ishikawa T, Takahashi T. Simultaneous thrombosis of the mesenteric artery and vein as a novel clinical manifestation of intravascular large B-cell lymphoma. Acta Haematol 2014; 132:108-11. [PMID: 24525901 DOI: 10.1159/000356682] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/23/2013] [Indexed: 01/23/2023]
Abstract
A 79-year-old man with a 2-month history of fever and weight loss was admitted to our hospital because of an acute abdomen. Abdominal CT scans showed marked sectional thickening and edema of the small intestine. On laparotomy, a 16-cm section of the small intestine was ischemic and necrotic; therefore, segmentectomy of the intestine was performed. A thrombus was noted at the stump of the mesenteric artery branch. Histopathological analysis of the resected intestine revealed fibrin thrombi in both mesenteric arteries and veins. Furthermore, a cluster of large, abnormal lymphoid cells bordering the intima of most branches of the mesenteric veins and small vessels was observed. Immunohistochemical analysis revealed that these abnormal cells were positive for CD20, leading to a diagnosis of intravascular large B-cell lymphoma (IVLBCL). The patient was successfully treated with standard R-CHOP chemotherapy; however, the lymphoma recurred in the central nervous system 18 months after the initial diagnosis, and the patient died. Simultaneous thrombosis of the mesenteric artery and vein is unusual as a clinical manifestation of IVLBCL. However, IVLBCL should be taken into consideration when ischemic disorders of unknown cause, accompanied by fever of unknown origin, are encountered.
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Affiliation(s)
- Hiroshi Arima
- Departments of Hematology and Clinical Immunology, Shinko Hospital, Kobe, Japan
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Makino K, Nakata J, Kawachi S, Hayashi T, Nakajima A, Yokoyama M. Treatment strategy for reducing the risk of rituximab-induced cytokine release syndrome in patients with intravascular large B-cell lymphoma: a case report and review of the literature. J Med Case Rep 2013; 7:280. [PMID: 24377366 PMCID: PMC3923559 DOI: 10.1186/1752-1947-7-280] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 09/30/2013] [Indexed: 01/14/2023] Open
Abstract
Introduction Intravascular large B-cell lymphoma is a rare aggressive disseminated disease characterized by the presence of lymphoma cells in small vessels without lymphadenopathy. Rituximab, a novel monoclonal antibody against the CD20 B-cell antigen, has been reported to be effective in treating intravascular large B-cell lymphoma. However, adverse events have been reported in association with rituximab infusion. Case presentation We report the case of a 54-year-old Japanese man diagnosed with Asian variant intravascular large B-cell lymphoma who died within five hours of the initiation of a first course of chemotherapy including rituximab. Autopsy results suggested that the patient died of severe systemic inflammatory response syndrome. A literature review revealed that rituximab administered during the second course of chemotherapy (instead of during the first course) appears to reduce the incidence of infusion reactions (from 48% to 15%) without altering the frequency of complete remission outcomes. Conclusions Our data indicate that the incidence of adverse reactions to rituximab can be markedly decreased if the tumor load is first reduced with an initial course of chemotherapy excluding rituximab. Future prospective studies of the timing of rituximab administration are warranted.
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Affiliation(s)
- Katsuhiro Makino
- Department of General Medicine, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano, Nakano-ku, Tokyo 164-8541, Japan.
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Oehler E, Soubiran G, Fabiani B, Legrand O, Rio B, Ghawche F. [Macrophage activation syndrome as the presenting manifestation of intravascular lymphoma]. Rev Med Interne 2013; 34:636-40. [PMID: 23660185 DOI: 10.1016/j.revmed.2012.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 08/29/2012] [Accepted: 10/01/2012] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Intravascular large B cell lymphoma is a neoplastic cell proliferation leading to the occlusion of the lumen of small vessels. This is a rare haematological malignancy, which is difficult to diagnose because of a heterogeneous clinical presentation. CASE REPORT We report a 62-year-old man who presented a macrophage activation syndrome as the presenting manifestation of an intravascular lymphoma. This association is frequently marked by a greater severity and clinical care requires an early and appropriate treatment. CONCLUSION Due to the polymorphism and the systemic presentation of intravascular large B cell lymphoma, the internist may be confronted with this disease, which is considered to be more severe if associated with a macrophage activation syndrome. Awareness of the intravascular large B cell lymphoma is important because the prognosis depends on the rapidity of the initiation of chemotherapy associated with rituximab.
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Affiliation(s)
- E Oehler
- Service de médecine interne, centre hospitalier de Polynésie française, 98713 Tahiti, Polynésie française.
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Geyer H, Karlin N, Palen B, Mesa R. Asian-variant intravascular lymphoma in the African race. Rare Tumors 2012; 4:e10. [PMID: 22532908 PMCID: PMC3325737 DOI: 10.4081/rt.2012.e10] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 12/12/2011] [Indexed: 01/28/2023] Open
Abstract
Intravascular Large B-cell lymphoma (IVLBCL) is an exceptionally rare form of non-Hodgkin lymphoma (NHL) distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laboratory data was notable for anemia, thrombocytopenia, elevated liver function tests, and hematuria. An extensive work-up for infectious, rheumatologic and malignant causes was negative. Her symptoms progressed and within two weeks, she was admitted for disseminated intravascular coagulation (DIC). Her course was complicated by diffuse pulmonary hemorrhage and ultimately, care was withdrawn. Autopsy identified widespread CD-20 positive intravascular large B-cell lymphoma with significant hepatosplenic involvement, characteristic of the Asian variant IVLBCL. This case uniquely highlights development of the Asian variant IVLBVL in a previously undescribed race. Identified by its intraluminal vascular growth pattern, IVLBCL generally spares lymphatic channels. Diagnosis and differentiation of this condition from other hematological malignancies via skin, visceral and bone marrow biopsy is imperative as anthracycline-containing chemotherapies may significantly improve clinical outcomes. This article outlines the common presentation, natural course, and treatment options of IVLBCL, along with the histopathology, immunohistochemistry, and chromosomal aberrations common to this condition.
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Affiliation(s)
- Holly Geyer
- Division of Hematology - Oncology, Mayo Clinic, Scottsdale, AZ, USA
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Yamashita Y, Kajiura D, Tang L, Hasegawa Y, Kinoshita T, Nakamura S, Akatsuka S, Toyokuni S, Mori N. XCR1 expression and biased VH gene usage are distinct features of diffuse large B-cell lymphoma initially manifesting in the bone marrow. Am J Clin Pathol 2011; 135:556-64. [PMID: 21411777 DOI: 10.1309/ajcpctdc5py3lxbp] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A total of 29 cases of diffuse large B-cell lymphoma initially manifesting in the bone marrow (BM-DLBCL) were analyzed for V(H) gene sequence, and expression microarray of chemokines and chemokine receptors and immunohistochemical analysis were done. Seminested polymerase chain reaction (PCR) and sequencing analyses of 18 cases revealed that the V(H) gene usage in 6 cases was restricted to V(H)3-7, in 3 cases to V(H)4-34, and in 2 cases to V(H)4-39, which were all previously reported to be autoreactive. In total, 14 of 18 V(H) genes were those associated with autoimmune diseases, including V(H)3-21, V(H)3-23, and V(H)3-48. Furthermore, cDNA microarray analysis specific for chemokine and chemokine receptors revealed that chemokine receptor XCR1 expression was significantly elevated in the BM-DLBCL cases (P < .05), which was confirmed by quantitative reverse transcriptase-PCR and immunohistochemical analysis. Expression of the chemokine receptor XCR1 and frequent usage of autoreactive V(H) genes seem to be distinct characteristics of BM-DLBCL.
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14
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Gioulis M, Ben G, Iuzzolino P, De Biasi F, Marchini C, Zambito Marsala S. Subacute cognitive disorders as initial presentation of intravascular lymphoma: a case report and review of literature. Neurol Sci 2010; 31:369-72. [PMID: 20300793 DOI: 10.1007/s10072-010-0232-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
Abstract
Intravascular lymphoma is a rare subtype of diffuse large B cell lymphoma, characterized by proliferation of mature B cells within the lumina of small and medium vessels of many organs, without parenchymal involvement. The clinical phenotype is extremely variegated; moreover, neurological symptoms such as encephalopathy and focal neurological deficits occur and often coincide with disease's debut. We described the clinical course of a patient with intravascular diffuse large B cell lymphoma presented with subacute cognitive decline without focal signs, later associated to aspecific general symptoms that rapidly evolved to a severe inexplicable encephalopathy accompanied to systemic failure.
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Iriyama N, Horikoshi A, Hatta Y, Kobayashi Y, Sawada S, Takeuchi J. Localized, splenic, diffuse large B-cell lymphoma presenting with hypersplenism: risk and benefit of splenectomy. Intern Med 2010; 49:1027-30. [PMID: 20519821 DOI: 10.2169/internalmedicine.49.3228] [Citation(s) in RCA: 9] [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
Herein we report a case of a localized, massive, diffuse large B-cell splenic lymphoma diagnosed by splenectomy. A 57-year-old man complaining of weight loss and abdominal pain, was admitted to our hospital. Enhanced computed tomography scanning showed an irregularly enhanced effect in the spleen suggesting a diffuse splenic tumor. Splenectomy was done and the operation progressed without severe complications. The resected spleen weighed 3,500 g. After the operation, the patient recovered from the pancytopenia and pathology diagnosed diffuse large B-cell lymphoma. Standard CHOP plus rituximab chemotherapy was given. Complete remission has continued for 30 months.
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Affiliation(s)
- Noriyoshi Iriyama
- Department of Internal Medicine, Nihon University School of Medicine, Nerima-Hikarigaoka Hospital, Tokyo, Japan.
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Horiguchi K, Hashimoto K, Hashizume M, Masuo T, Suto M, Okajo J, Handa H, Kaneko Y, Yokoo H, Sasaki A, Okada S, Yamada M, Tsukamoto N, Nojima Y, Nakazato Y, Mori M. Primary bilateral adrenal diffuse large B-cell lymphoma demonstrating adrenal failure. Intern Med 2010; 49:2241-6. [PMID: 20962443 DOI: 10.2169/internalmedicine.49.3941] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary adrenal lymphoma (PAL) is extremely rare although involvement of malignant lymphoma into adrenals is common. We report a case of a 58-year-old man with bilateral PAL who demonstrated adrenal insufficiency. Primary large B-cell lymphoma was proven by a computed tomography-guided needle biopsy of the adrenal tumor. Although a complete remission was once achieved by combination chemotherapy plus rituximab, a recurrence occurred with brain metastasis leading to his death. We concluded that PAL should be considered as a possible cause of bilateral adrenal incidentalomas with progressive adrenal insufficiency.
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MESH Headings
- Adrenal Gland Neoplasms/complications
- Adrenal Gland Neoplasms/diagnosis
- Adrenal Gland Neoplasms/drug therapy
- Adrenal Insufficiency/etiology
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Brain Neoplasms/drug therapy
- Brain Neoplasms/radiotherapy
- Brain Neoplasms/secondary
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cytarabine/administration & dosage
- Dexamethasone/administration & dosage
- Doxorubicin/administration & dosage
- Fatal Outcome
- Humans
- Incidental Findings
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/radiotherapy
- Male
- Middle Aged
- Neoplasm Recurrence, Local
- Neoplasms, Multiple Primary/complications
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/drug therapy
- Prednisone/administration & dosage
- Rituximab
- Vincristine/administration & dosage
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Affiliation(s)
- Kazuhiko Horiguchi
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi
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17
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Yamamoto T, Morita K, Iriyama N, Wakui K, Hiroi A, Sawada T, Masuda A, Kobayashi M. Intravascular large B-cell lymphoma of the uterus: a case with favorable clinical outcome. Int J Surg Pathol 2009; 19:672-6. [PMID: 19948641 DOI: 10.1177/1066896909346273] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intravascular lymphoma (IVL) of the uterus, a rare manifestation of malignant lymphoma, was diagnosed in a 71-year-old woman, who had fever, edema, and genital bleeding. Only 4 cases of uterine IVL have been reported in detail in the literature in English, to the author's knowledge. The patient was treated with total hysterectomy with bilateral salpingo-oophorectomy, accompanied by subsequent chemotherapy in combination with rituximab. Preoperative endometrial cytology and biopsy showed atypical lymphocytes intermingled with nonneoplastic epithelial cells. Intravascular proliferation of atypical lymphocytes was detected by histological examination of the resected materials, in which almost the entire uterine structure, including a large endometrial polyp, ovaries, and uterine tubes were involved. Immunohistochemically, tumor cells were positive for CD20 and CD79a and negative for CD5 and CD10. In situ hybridization for Epstein-Barr virus was negative. IVL generally has a poor prognosis. However, in the present case, the patient has been disease free for at least 51 months, and a favorable outcome can be expected.
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Affiliation(s)
- Tomoko Yamamoto
- Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
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18
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Kong YY, Dai B, Sheng WQ, Yang WT, Wang CF, Kong JC, Shi DR. Intravascular large B-cell lymphoma with cutaneous manifestations: a clinicopathologic, immunophenotypic and molecular study of three cases. J Cutan Pathol 2009; 36:865-70. [DOI: 10.1111/j.1600-0560.2008.01168.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Intravascular large B-cell lymphoma: remission after rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy. J Am Acad Dermatol 2009; 61:885-8. [PMID: 19632742 DOI: 10.1016/j.jaad.2008.12.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 12/16/2008] [Accepted: 12/16/2008] [Indexed: 12/14/2022]
Abstract
Intravascular lymphoma is an uncommon, very aggressive extranodal non-Hodgkin lymphoma that most frequently involves the skin and central nervous system. Most cases are of B-cell origin; T-cell phenotype is extremely rare. Malignant cells proliferate within the lumens of capillaries, arterioles, venules, and small arteries; vascular occlusion is responsible for the clinical signs and symptoms. The prognosis of this high-grade B-cell lymphoma has improved since the introduction of the anti-CD20 monoclonal antibody, rituximab. We describe a case of B-cell intravascular lymphoma successfully treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisolone.
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20
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Intravascular large B-cell lymphoma with involvement of the abdominal subcutis: a case report and literature review. Int J Hematol 2009; 89:348-351. [PMID: 19255830 DOI: 10.1007/s12185-009-0262-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 01/19/2009] [Accepted: 01/23/2009] [Indexed: 10/21/2022]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of diffuse large B-cell lymphoma (DLBCL). It commonly presents with a variety of symptoms due to occlusion of small vessels by tumor cells in different organ systems. Clinically patients may present with generalized symptoms such as fever and malaise. In western patients, there is a 'cutaneous variant' of IVLBCL, which demonstrates cutaneous involvement only. However, Asian patients show hemophagocytosis, which is typical of the 'Asian variant'. Here we report a case of IVLBCL in a Chinese individual who presented with a huge mass in the subcutis of the abdomen.
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21
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Shimada K, Matsue K, Yamamoto K, Murase T, Ichikawa N, Okamoto M, Niitsu N, Kosugi H, Tsukamoto N, Miwa H, Asaoku H, Kikuchi A, Matsumoto M, Saburi Y, Masaki Y, Yamaguchi M, Nakamura S, Naoe T, Kinoshita T. 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; 26:3189-95. [DOI: 10.1200/jco.2007.15.4278] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose To evaluate the safety and efficacy of rituximab-containing chemotherapies for intravascular large B-cell lymphoma (IVLBCL). Patients and Methods We retrospectively analyzed 106 patients (59 men, 47 women) with IVLBCL who received chemotherapy either with rituximab (R-chemotherapy, n = 49) or without rituximab (chemotherapy, n = 57) between 1994 and 2007 in Japan. The median patient age was 67 years (range, 34 to 84 years). The International Prognostic Index was high-intermediate/high in 97% of patients. Results The complete response rate was higher for patients in the R-chemotherapy group (82%) than for those in the chemotherapy group (51%; P = .001). The median duration of follow-up for surviving patients was 18 months (range, 1 to 95 months). Progression-free survival (PFS) and overall survival (OS) rates at 2 years after diagnosis were significantly higher for patients in the R-chemotherapy group (PFS, 56%; OS, 66%) than for patients in the chemotherapy group (PFS, 27% with P = .001; OS, 46% with P = 0.01). Multivariate analysis revealed that the use of rituximab was favorably associated with PFS (hazard ratio [HR], 0.45; 95% CI, 0.25 to 0.80; P = .006) and OS (HR, 0.42; 95% CI, 0.21 to 0.85; P = .016). Treatment-related death was observed in three patients (6%) who received R-chemotherapy and in five patients (9%) who received chemotherapy. Conclusion Our data suggest improved clinical outcomes for patients with IVLBCL in the rituximab era. Future prospective studies of rituximab-containing chemotherapies are warranted.
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Affiliation(s)
- Kazuyuki Shimada
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Kosei Matsue
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Kazuhito Yamamoto
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Takuhei Murase
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Naoaki Ichikawa
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Masataka Okamoto
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Nozomi Niitsu
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Hiroshi Kosugi
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Norifumi Tsukamoto
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Hiroshi Miwa
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Hideki Asaoku
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Ako Kikuchi
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Morio Matsumoto
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Yoshio Saburi
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Yasufumi Masaki
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Motoko Yamaguchi
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Shigeo Nakamura
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Tomoki Naoe
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
| | - Tomohiro Kinoshita
- From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health
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22
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Nakamichi N, Fukuhara S, Aozasa K, Morii E. NK-cell intravascular lymphomatosis--a mini-review. Eur J Haematol 2008; 81:1-7. [PMID: 18462254 DOI: 10.1111/j.1600-0609.2008.01089.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The majority of cases of intravascular lymphomatosis (IVL) is derived from B cells. However, IVL may also arise from T cells, or more rarely NK cells. The clinicopathological findings in six cases of NK-cell IVL (NK-IVL), including one new case, were summarised and compared with B-cell IVL (B-IVL) and T-cell IVL (T-IVL). Earlier onset of disease and female predominance were found in NK-IVL. NK-IVL was typically Epstein-Barr virus (EBV)-positive, whereas EBV was rarely detected in B-IVL. Cutaneous manifestations were common in NK-IVL with constant EBV infection. B-IVL showed a more favourable prognosis than T- or NK-IVL. Irrespective of immunophenotype, however, IVL showed a less favourable prognosis than ordinary lymphomas within the same immunophenotype. In summary, IVL of the B-, T- and NK-cell phenotypes is clinicopathologically distinct and shows similarities to their more common counterparts, i.e. diffuse large B-cell lymphoma, peripheral T-cell lymphoma, unspecified and extranodal NK/T-cell lymphoma, nasal type.
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Affiliation(s)
- Naoto Nakamichi
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
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