A case of intravascular large B-cell lymphoma (IVLBCL) with no abnormal findings on chest computed tomography diagnosed by random transbronchial lung biopsy.

Abstract

A 58-year-old woman was admitted with refractory fever despite receiving broad-spectrum antibiotics. She had hypoxemia, severe anemia, elevated levels of serum lactic dehydrogenase and soluble interleukin-2 receptor, and a positive direct Coombs test, which suggested an underlying autoimmune hemolytic anemia (AIHA). Chest computed tomography (CT) showed no abnormal findings, but she had hypoxia, and her alveolar-arterial oxygen difference (A-aDO2) was increased. A random transbronchial lung biopsy (TBLB) was performed, and pathological analysis showed massive proliferation of tumor cells in the lumina of the small vessels. Intravascular large B-cell lymphoma (IVLBCL) was diagnosed, and her general status improved after chemotherapy.

• Authors: Norihito Kaku, Masafumi Seki, Seiji Doi, Tomayoshi Hayashi, Daisuke Imanishi, Yoshifumi Imamura, Shintaro Kurihara, Taiga Miyazaki, Koichi Izumikawa, Hiroshi Kakeya, Yoshihiro Yamamoto, Katsunori Yanagihara, Takayoshi Tashiro, Shigeru Kohno
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 49 Issue 24 Pg. 2697-701 ( 2010) ISSN: 1349-7235 [Electronic] Japan
• PMID: 21173545 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Biopsy
• Bronchoscopy (methods)
• Female
• Humans
• Lung Neoplasms (complications, diagnostic imaging, pathology)
• Lymphoma, Large B-Cell, Diffuse (complications, diagnostic imaging, pathology)
• Middle Aged
• Tomography, X-Ray Computed (methods)