Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek
We are reporting the first documented case of intravascular large B-cell lymphoma (IVLBCL) manifesting in the endomysial and perimysial capillaries with its associated diagnostic dilemma. Our patient presented with progressive paraplegia. Initial laboratories were remarkable for hyponatremia, hypoch...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-11-01
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| Series: | Case Reports in Oncology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/525843 |
| _version_ | 1828125619516342272 |
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| author | JiaXi Dong Daniel Barnett Nathanael Adjei-Kyeremeh Heather Bartz |
| author_facet | JiaXi Dong Daniel Barnett Nathanael Adjei-Kyeremeh Heather Bartz |
| author_sort | JiaXi Dong |
| collection | DOAJ |
| description | We are reporting the first documented case of intravascular large B-cell lymphoma (IVLBCL) manifesting in the endomysial and perimysial capillaries with its associated diagnostic dilemma. Our patient presented with progressive paraplegia. Initial laboratories were remarkable for hyponatremia, hypochloremia, lactic acidosis, elevated C-reactive protein, and lactate dehydrogenase. The bone marrow biopsy was unrevealing. However, a subsequent muscle biopsy confirmed the diagnosis of IVLBCL. As hyponatremia, endocrinopathies, connective tissue disease, rheumatological disorders, and occult cancer could all present similarly, our patient is a unique diagnostic dilemma. Randomized skin biopsy remains the best way to diagnose this disease, and rituximab-based chemotherapy with high-dose intrathecal methotrexate has proven to be a safe and effective regimen. With this initial evidence of IVLBCL involving the endomysial and perimysial capillary, we believe that muscle biopsy could be of value in diagnosing IVLBCL patients with neuromuscular symptoms. |
| first_indexed | 2024-04-11T15:23:27Z |
| format | Article |
| id | doaj.art-6dafd84f6aa3457eac55f171cc70fd4c |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-04-11T15:23:27Z |
| publishDate | 2022-11-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-6dafd84f6aa3457eac55f171cc70fd4c2022-12-22T04:16:18ZengKarger PublishersCase Reports in Oncology1662-65752022-11-0115393694110.1159/000525843525843Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and SeekJiaXi DongDaniel BarnettNathanael Adjei-KyeremehHeather BartzWe are reporting the first documented case of intravascular large B-cell lymphoma (IVLBCL) manifesting in the endomysial and perimysial capillaries with its associated diagnostic dilemma. Our patient presented with progressive paraplegia. Initial laboratories were remarkable for hyponatremia, hypochloremia, lactic acidosis, elevated C-reactive protein, and lactate dehydrogenase. The bone marrow biopsy was unrevealing. However, a subsequent muscle biopsy confirmed the diagnosis of IVLBCL. As hyponatremia, endocrinopathies, connective tissue disease, rheumatological disorders, and occult cancer could all present similarly, our patient is a unique diagnostic dilemma. Randomized skin biopsy remains the best way to diagnose this disease, and rituximab-based chemotherapy with high-dose intrathecal methotrexate has proven to be a safe and effective regimen. With this initial evidence of IVLBCL involving the endomysial and perimysial capillary, we believe that muscle biopsy could be of value in diagnosing IVLBCL patients with neuromuscular symptoms.https://www.karger.com/Article/FullText/525843intravascular large b-cell lymphomadiffuse large b-cell lymphomamuscle biopsy |
| spellingShingle | JiaXi Dong Daniel Barnett Nathanael Adjei-Kyeremeh Heather Bartz Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek Case Reports in Oncology intravascular large b-cell lymphoma diffuse large b-cell lymphoma muscle biopsy |
| title | Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek |
| title_full | Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek |
| title_fullStr | Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek |
| title_full_unstemmed | Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek |
| title_short | Diagnosing Intravascular Large B-Cell Lymphoma: A Tale of Hide and Seek |
| title_sort | diagnosing intravascular large b cell lymphoma a tale of hide and seek |
| topic | intravascular large b-cell lymphoma diffuse large b-cell lymphoma muscle biopsy |
| url | https://www.karger.com/Article/FullText/525843 |
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