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  • Title: Intravascular large B-cell lymphoma with a fulminant clinical course: a case report with definite diagnosis post mortem.
    Author: Fiegl M, Greil R, Pechlaner C, Krugmann J, Dirnhofer S.
    Journal: Ann Oncol; 2002 Sep; 13(9):1503-6. PubMed ID: 12196378.
    Abstract:
    A patient is described who presented with pancytopenia, splenomegaly and excessively elevated lactate dehydrogenase levels in concurrence with signs of extramedullary hematopoiesis. Although initially considered in the differential diagnostic spectrum, a highly aggressive lymphoma could not be identified before the patient died, 6 weeks after admission. Even an intensive diagnostic work-up including splenectomy and repeated bone marrow biopsies was inconclusive. Finally, the diagnosis of an intravascular large B-cell lymphoma, a highly aggressive clinical subtype of a diffuse large B-cell lymphoma, spreading within vascular structures of multiple organs was established by autopsy. Intravascular large B-cell lymphoma is often not diagnosed before death due to the exclusive intravascular growth pattern of the tumor cells and a fulminant clinical course. The heterogeneous clinical features of this lymphoma subtype are discussed.
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