Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; Department of Pathology, Medical College, Qingdao University, Qingdao, PR China.
Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, PR China.
Acta Histochem. 2014 Jun;116(5):993-6. doi: 10.1016/j.acthis.2013.12.001. Epub 2014 Jan 10.
Primary intravascular large B cell lymphoma (IVLBCL) of the endometrium is extremely rare. So far, only 5 cases have been reported in the English literature. We now report a new case of endometrial IVLBCL which exhibited distinct clinicopathological characteristics and meaningful laboratory tests, and also review the literature. A 66-year-old woman showed symptoms of chronic cough and choking sensation for 4 months. Following three days of vaginal bleeding she presented for examination and diagnosis. The percentage of monocytes in the blood was double that of normal levels. There was a polyp in the endometrium, which showed a number of medium-large lymphoid cells in dilated capillaries. Immunohistochemically, the lymphoid cells were immunoreactive to CD20, CD79a, Mum-1 and Foxp-1 with 85% cells immunoreactive to Ki-67. IVLBCL of the endometrium is rare and the clinical diagnosis is very difficult. Unexplained fever of old people and abnormal laboratory tests such as obvious abnormal monocyte distribution in the blood should alert the clinical doctor to the possibility of IVLBCL. A correct diagnosis mainly depends on pathological tests and immunohistochemical labeling. The prognosis of IVLBCL is poor and few patients survive longer than one year.
原发性血管内大 B 细胞淋巴瘤（IVLBCL）极为罕见。迄今为止，英文文献中仅报道了 5 例。我们现报道 1 例新的子宫内膜 IVLBCL 病例，其表现出独特的临床病理特征和有意义的实验室检查，并复习文献。1 例 66 岁女性，慢性咳嗽和呛咳 4 个月，阴道出血 3 天后就诊。血常规示单核细胞百分比是正常值的两倍。子宫内膜有息肉，扩张的毛细血管内有大量中大型淋巴样细胞。免疫组化示，淋巴样细胞 CD20、CD79a、Mum-1 和 Foxp-1 阳性，85%的细胞 Ki-67 阳性。子宫内膜 IVLBCL 罕见，临床诊断非常困难。老年人不明原因发热和血液中单核细胞分布异常等实验室检查异常应引起临床医生警惕 IVLBCL 的可能。正确诊断主要依赖于病理检查和免疫组化标记。IVLBCL 的预后较差，很少有患者存活超过 1 年。
