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Intravascular B-cell lymphoma
Ochsner Clinic Foundation, New Orleans, LA
Intravascular lymphoma (IVL) is a rare and aggressive variant of diffuse large cell lymphoma. IVL is defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of capillaries, small veins, and arteries with little or no parenchymal involvement. IVL has a tendency to mimic other diseases, so a high index of clinical suspicion is warranted to make a diagnosis. Most cases are diagnosed postmortem. The median survival is approximately 5 months. A 73-year-old female presented with a complaint of persistent right upper and lower extremity weakness, waxing and waning confusion, and a weight loss of 45 pounds over 3 months. Physical examination revealed decreased strength, sensation, and deep-tendon reflexes on the affected side. Cranial imaging revealed multiple infarcts in her left parietal and occipital lobes. Final diagnosis was made by a brain biopsy. She received high-dose methotrexate, procarbazine, and vincristine, which resulted in marked improvement in her clinical status. However, the patient decided against further chemotherapy and opted to be discharged to inpatient hospice.
| Commun Oncol 2005;2:55–60 | full text |  183 kb |