Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis
Intravascular lymphoma is a rare type of lymphoma, characterized by growth of lymphoma cells within the microvasculature. The majority of the cases are of B-cell lineage, although rare examples of T or NK lineage have also been reported. The lymphoma is usually widely disseminated in the vascular sp...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2018/5364985 |
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| author | Ifeyinwa Emmanuela Obiorah Metin Ozdemirli |
| author_facet | Ifeyinwa Emmanuela Obiorah Metin Ozdemirli |
| author_sort | Ifeyinwa Emmanuela Obiorah |
| collection | DOAJ |
| description | Intravascular lymphoma is a rare type of lymphoma, characterized by growth of lymphoma cells within the microvasculature. The majority of the cases are of B-cell lineage, although rare examples of T or NK lineage have also been reported. The lymphoma is usually widely disseminated in the vascular spaces of any organ at the time of diagnosis including the skin and bone marrow. Lymph nodes are typically spared. The clinical picture depends on the specific organ involvement making the correct diagnosis very difficult. Here, we report a case of intravascular large B-cell lymphoma diagnosed postmortem on a 69-year-old African-American male who presented with unilateral proptosis and visual loss. An initial diagnosis of temporal arteritis was made and the patient received corticosteroids. However, the patient developed multiorgan failure and expired. On autopsy, there was disseminated intravascular lymphoma involving predominantly vessels within the heart, kidneys, liver, stomach, lungs, adrenal glands, small intestine, bladder, thyroid, and brain. Interestingly, there was also partial involvement of the retroperitoneal lymph nodes which is an unusual presentation in this disorder. Immunohistochemical staining showed that the lymphoma cells were positive for CD20, indicating B-cell phenotype. This case supports the “mimicking nature” of this rare entity with an unusual presentation with proptosis and visual loss, simulating temporal arteritis and a rare involvement of the retroperitoneal lymph nodes. The presentation of intravascular large B-cell lymphoma can vary, and the key to diagnosis is dependent on histopathology and immunohistochemistry. Increased awareness, early tissue diagnosis, and prompt chemotherapy are crucial for this otherwise lethal disease. |
| format | Article |
| id | doaj-art-5c919c33df8a47c4bdcd3870a1350666 |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-5c919c33df8a47c4bdcd3870a13506662025-02-03T01:12:11ZengWileyCase Reports in Rheumatology2090-68892090-68972018-01-01201810.1155/2018/53649855364985Intravascular Large B-Cell Lymphoma Mimicking Temporal ArteritisIfeyinwa Emmanuela Obiorah0Metin Ozdemirli1Department of Pathology, Medstar Georgetown University Hospital, Washington, DC, USADepartment of Pathology, Medstar Georgetown University Hospital, Washington, DC, USAIntravascular lymphoma is a rare type of lymphoma, characterized by growth of lymphoma cells within the microvasculature. The majority of the cases are of B-cell lineage, although rare examples of T or NK lineage have also been reported. The lymphoma is usually widely disseminated in the vascular spaces of any organ at the time of diagnosis including the skin and bone marrow. Lymph nodes are typically spared. The clinical picture depends on the specific organ involvement making the correct diagnosis very difficult. Here, we report a case of intravascular large B-cell lymphoma diagnosed postmortem on a 69-year-old African-American male who presented with unilateral proptosis and visual loss. An initial diagnosis of temporal arteritis was made and the patient received corticosteroids. However, the patient developed multiorgan failure and expired. On autopsy, there was disseminated intravascular lymphoma involving predominantly vessels within the heart, kidneys, liver, stomach, lungs, adrenal glands, small intestine, bladder, thyroid, and brain. Interestingly, there was also partial involvement of the retroperitoneal lymph nodes which is an unusual presentation in this disorder. Immunohistochemical staining showed that the lymphoma cells were positive for CD20, indicating B-cell phenotype. This case supports the “mimicking nature” of this rare entity with an unusual presentation with proptosis and visual loss, simulating temporal arteritis and a rare involvement of the retroperitoneal lymph nodes. The presentation of intravascular large B-cell lymphoma can vary, and the key to diagnosis is dependent on histopathology and immunohistochemistry. Increased awareness, early tissue diagnosis, and prompt chemotherapy are crucial for this otherwise lethal disease.http://dx.doi.org/10.1155/2018/5364985 |
| spellingShingle | Ifeyinwa Emmanuela Obiorah Metin Ozdemirli Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis Case Reports in Rheumatology |
| title | Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis |
| title_full | Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis |
| title_fullStr | Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis |
| title_full_unstemmed | Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis |
| title_short | Intravascular Large B-Cell Lymphoma Mimicking Temporal Arteritis |
| title_sort | intravascular large b cell lymphoma mimicking temporal arteritis |
| url | http://dx.doi.org/10.1155/2018/5364985 |
| work_keys_str_mv | AT ifeyinwaemmanuelaobiorah intravascularlargebcelllymphomamimickingtemporalarteritis AT metinozdemirli intravascularlargebcelllymphomamimickingtemporalarteritis |