Hoshino A, Kawada E, Ukita T, Itoh K, Sakamoto H, Fujita K, Mantani N, Kogure T, Tamura J
Department of General Medicine, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Am J Hematol. 2004 Jul;76(3):236-9. doi: 10.1002/ajh.20099.
Intravascular lymphomatosis (IVL) is a rare systemic disease characterized by proliferation of lymphoid cells within the lumina of small arteries, veins, and capillaries. Diagnosis requires skin, liver, lung, bone marrow, renal, meningeal, or brain vessel biopsy but is often made only when the illness has progressed or post mortem because early involvement of organs was not evident. We report a case of IVL presenting as fever of unknown origin (FUO). In this case, gallium scintigraphy and computed tomography (CT) showed no evidence of malignancy, whereas (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased FDG uptake in the sternum, left and right vertebra, humerus, femur, and especially ilium. The diagnosis was made on iliac bone marrow biopsy examination. FDG-PET was useful for the detection of spread of disease in a patient with IVL suffering from FUO.
血管内淋巴瘤（IVL）是一种罕见的全身性疾病，其特征是小动脉、静脉和毛细血管腔内的淋巴细胞增殖。诊断需要进行皮肤、肝脏、肺、骨髓、肾脏、脑膜或脑血管活检，但通常只有在病情进展或死后才得以确诊，因为早期器官受累并不明显。我们报告一例表现为不明原因发热（FUO）的IVL病例。在该病例中，镓闪烁扫描和计算机断层扫描（CT）未显示恶性肿瘤迹象，而（18）F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）显示胸骨、左右椎骨、肱骨、股骨，尤其是髂骨的FDG摄取增加。通过髂骨髓活检检查做出了诊断。FDG-PET有助于检测患有FUO的IVL患者的疾病扩散情况。
