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Vol.53 No.2 contents Japanese/English

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Article in Japanese

- Case Report -

A Case of Asian Variant Intravascular Large B-cell Lymphoma Diagnosed Based on a Thoracoscopic Lung Biopsy That Exhibited Remission and Exacerbation on Computed Tomography

Kakuhiro Yamaguchi1, Soichi Kitaguchi1, Mayuko Kagawa1, Takashi Ogawa1, Fumihiro Sugahara1, Hiromi Egawa1
1Department of Respiratory Medicine, Hiroshima City Asa Hospital, Japan

Objective. We herein report a case of Asian variant intravascular large B-cell lymphoma which was diagnosed based on the results of a thoracoscopic lung biopsy that exhibited remission and exacerbation on computed tomography (CT). Case. A 53-year-old male presented to our hospital with dyspnea. On a routine examination, chest radiography showed an abnormal shadow. Chest CT revealed areas of diffuse ground-glass opacity in the bilateral lungs. We suspected a diagnosis of hypersensitivity pneumonitis because the patient was in remission without receiving treatment. Eleven months later, he again presented with dyspnea at our hospital. Repeat chest CT revealed areas of diffuse ground-glass opacity in the bilateral lungs, and the patient experienced high fever spikes during the following month. He was diagnosed with Asian variant intravascular large B-cell lymphoma, as the laboratory data met the diagnostic criteria for hemophagocytic syndrome and a thoracoscopic lung biopsy revealed atypical cells in small vessels. The cells were positive for CD79α, MUM1, CD10 and BCL6 based on immunohistochemistry, and IgH gene rearrangement was observed. Conclusion. We diagnosed a case of Asian variant intravascular large B-cell lymphoma with spontaneous remission. We herein discuss the imaging findings, mechanisms and treatment with a review of the pertinent literature.
key words: Intravascular large B-cell lymphoma, Hemophagocytic syndrome, Remission

Received: December 13, 2012
Accepted: March 1, 2013

JJLC 53 (2): 99-103, 2013

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