Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

14 August 2019 : Case report  Japan

Intravascular Large B-Cell Lymphoma Presenting with Hypoxemia without any Abnormalities on Standard Imaging Studies

Challenging differential diagnosis, Rare disease

Midori Tokushima1AEF, Naoko E. Katsuki1AEF, Masaki Tago1AEF*, Shu-ichi Yamashita1AE

DOI: 10.12659/AJCR.916877

Am J Case Rep 2019; 20:1199-1204

Abstract

BACKGROUND: Intravascular large B-cell lymphoma (IVLBCL) is characteristically diagnosed by histological examination of biopsies of bone marrow or randomly harvested skin specimens in the absence of any diagnostic abnormalities on imaging studies, including computed tomography (CT). In particular, diagnosis of IVLBCL with pulmonary manifestations is challenging, because even in patients with severe respiratory failure, there are rarely abnormalities on standard imaging studies.

CASE REPORT: A 75-year-old female presented with fatigue, weight loss, and high fever with chills for 3 months. Blood examinations on her initial visit to her primary physician showed high concentrations of C-reactive protein, lactate dehydrogenase, and soluble interleukin-2 receptor. There were no abnormalities on imaging studies. She was subsequently admitted to our hospital because of development of dyspnea over time (4 months after symptom onset). Although she was suspected of having IVLBCL, repeated biopsies from bone marrow, skin, liver, and lung did not result in a diagnosis. Finally, a lung biopsy obtained by video-associated thoracic surgery (VATS) from the right lung base, where fluorine-18 fluorodeoxyglucose positron emission tomography had shown high uptake, resulted in a definite diagnosis of IVLBCL.

CONCLUSIONS: Highly invasive procedures such as thoracoscopic lung resection may be required to diagnose IVLBCL with pulmonary manifestations which can cause severe respiratory failure in the absence of any abnormalities on standard imaging studies.

Keywords: Anoxia, Lymphoma, B-Cell, Positron-Emission Tomography, Thoracic Surgery, Video-Assisted, Thoracoscopy, Biopsy, Dyspnea, Fluorodeoxyglucose F18, Lymphoma, Large B-Cell, Diffuse

Add Comment 0 Comments

In Press

Case report  China

Minimally Invasive Management of Infantile Dacryocystitis with Lacrimal Abscess: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946588  

Case report  Poland

Varicella Zoster Virus-Induced Retinitis and Retinal Detachment in an Immunocompetent Patient: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946011  

Case report  Belgium

A 37-Year-Old Man with Multifocal Bilateral Malignant Testicular Large-Cell Calcifying Sertoli Cell Tumors ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.945910  

Case report  Saudi Arabia

Corneal Ring Infiltrate Following Micropulse Cyclophotocoagulation

Am J Case Rep In Press; DOI: 10.12659/AJCR.945852  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 88,859

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 50,114

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 25,398

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 22,663

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923