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Article in Japanese
A case of intravascular lymphoma successfully diagnosed by transbronchial lung biopsy despite negative results obtained by random skin biopsy and bone marrow biopsies
Daisuke Tsutsumia Toshihiro Isiia,b Koh Abea Yuko Usagawab Haruto Nishidac Eishi Miyazakia
aDepartment of General Medicine, Oita University Faculty of Medicine
bDepartment of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine
cDepartment of Diagnostic Pathology, Oita University Faculty of Medicine
A 59-year-old man was admitted to our hospital with high fever, non-productive cough, and dyspnea on exertion. Blood tests showed pancytopenia and elevated levels of lactate dehydrogenase and soluble interleukin-2 receptor, suggesting a diagnosis of intravascular lymphoma. Despite lower PaO2 and low pulmonary diffusing capacity for carbon monoxide, chest computed tomography (CT) scans did not show any abnormalities. Both bone marrow biopsy and random skin biopsy revealed negative results. (18F)-fluorodeoxyglucose (FDG)-positron emission tomography (PET) CT showed intense FDG uptake in both lower lungs. Transbronchial lung biopsy confirmed the diagnosis of intravascular large B cell lymphoma. In addition, lymphoma cells were found in specimens from the second random skin biopsy. We discuss ways to obtain histopathological confirmation of intravascular lymphoma of the lung.
Intravascular lymphoma Transbronchial lung biopsy Random skin biopsy Bone marrow biopsy Positron emission tomography
Received 16 Feb 2017 / Accepted 10 Aug 2017
AJRS, 6(6): 463-467, 2017