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Abstract

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Article in Japanese

Case Report

A case of intravascular lymphoma successfully diagnosed by transbronchial lung biopsy despite negative results obtained by random skin biopsy and bone marrow biopsies

Daisuke Tsutsumia  Toshihiro Isiia,b  Koh Abea  Yuko Usagawab  Haruto Nishidac  Eishi Miyazakia 

aDepartment of General Medicine, Oita University Faculty of Medicine
bDepartment of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine
cDepartment of Diagnostic Pathology, Oita University Faculty of Medicine

ABSTRACT

A 59-year-old man was admitted to our hospital with high fever, non-productive cough, and dyspnea on exertion. Blood tests showed pancytopenia and elevated levels of lactate dehydrogenase and soluble interleukin-2 receptor, suggesting a diagnosis of intravascular lymphoma. Despite lower PaO2 and low pulmonary diffusing capacity for carbon monoxide, chest computed tomography (CT) scans did not show any abnormalities. Both bone marrow biopsy and random skin biopsy revealed negative results. (18F)-fluorodeoxyglucose (FDG)-positron emission tomography (PET) CT showed intense FDG uptake in both lower lungs. Transbronchial lung biopsy confirmed the diagnosis of intravascular large B cell lymphoma. In addition, lymphoma cells were found in specimens from the second random skin biopsy. We discuss ways to obtain histopathological confirmation of intravascular lymphoma of the lung.

KEYWORDS

Intravascular lymphoma  Transbronchial lung biopsy  Random skin biopsy  Bone marrow biopsy  Positron emission tomography 

Received 16 Feb 2017 / Accepted 10 Aug 2017

AJRS, 6(6): 463-467, 2017

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