Inooka G, Ishikawa S, Saito T, Saito K, Kamoshida T, Kuzuya T
Department of Medicine, Jichi Medical School, Tochigi, Japan.
Intern Med. 1992 May;31(5):666-70. doi: 10.2169/internalmedicine.31.666.
A 75-year-old woman suffered from intermittent high-grade fever and hypertension without any focal sign. Serum lactic dehydrogenase (LDH) was markedly elevated. The fever was resistant to antibiotics and temporarily sensitive to prednisolone. She had heart failure and died. Postmortem examination revealed intravascular proliferation of B lymphocytes, indicative of the diagnosis of intravascular lymphomatosis. The clinical diagnosis is usually very difficult because of the absence of pathognomonic clinical manifestations.