Recurrence of nodal diffuse large B-cell lymphoma as intravascular large B-cell lymphoma: is an intravascular component at initial diagnosis predictive?

Abstract

We report a case of a 59-year-old man who first presented with a nodal diffuse large B-cell lymphoma that later relapsed as an intravascular large B-cell lymphoma. In the initial biopsy specimen, a few intranodal small vessels that contained large lymphoma cells were noted. After 8 months of multiagent chemotherapy, clinical remission was attained. Two years after the initial diagnosis of nodal diffuse large B-cell lymphoma, the patient presented with a rapid onset of multiorgan failure, which at autopsy was shown to be due to intravascular large B-cell lymphoma. Molecular genetic studies showed that these 2 lymphomas had immunoglobulin heavy-chain gene rearrangements that were of identical size, suggesting that they were derived from the same clone. To our knowledge, this is the first report of a nodal large B-cell lymphoma that relapsed as an intravascular large B-cell lymphoma. Although this report is of only a single case, the presence of a relatively inconspicuous intravascular component in an otherwise typical nodal large B-cell lymphoma may be predictive and could affect clinical decisions regarding diagnosis, monitoring, and prognosis of such lymphomas.

• Authors: Xian-Feng Zhao, Amy M Sands, Peter T Ostrow, Regina Halbiger, James T Conway, Adam Bagg
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 129 Issue 3 Pg. 391-4 (Mar 2005) ISSN: 1543-2165 [Electronic] United States
• PMID: 15737037 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Fatal Outcome
• Humans
• Lymphoma, B-Cell (diagnosis)
• Lymphoma, Large B-Cell, Diffuse (diagnosis)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis)
• Vascular Neoplasms (diagnosis)