Zhang Weiwei, Tang Ying
Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
Healthcare (Basel). 2024 Jul 22;12(14):1455. doi: 10.3390/healthcare12141455.
A 55-year-old woman had remarkably generalized telangiectasia. Large atypical lymphoid cells were found within the lumen of small vessels, and CD20 was positive in her third skin biopsy. She was diagnosed with intravascular large B-cell lymphoma (IVLBCL) and went into remission of the skin manifestations after seven courses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) and four courses of intravenous high-dose methotrexate (HD MTX). To our knowledge, this is the first case report of IVLBCL with generalized telangiectasia in China. From a review of the literature, we found that generalized telangiectasia is a remarkable manifestation of intravascular lymphoma, and the differential diagnosis of intravascular lymphoma and panniculitis or vasculitis is very important. When the diagnosis is confusing, multiple skin biopsies are useful.
一名55岁女性患有明显的全身性毛细血管扩张症。在小血管腔内发现了大量非典型淋巴细胞，其第三次皮肤活检中CD20呈阳性。她被诊断为血管内大B细胞淋巴瘤（IVLBCL），在接受七个疗程的R-CHOP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松龙）和四个疗程的静脉高剂量甲氨蝶呤（HD MTX）治疗后，皮肤表现得到缓解。据我们所知，这是中国首例伴有全身性毛细血管扩张症的IVLBCL病例报告。通过文献回顾，我们发现全身性毛细血管扩张症是血管内淋巴瘤的显著表现，血管内淋巴瘤与脂膜炎或血管炎的鉴别诊断非常重要。当诊断存在困惑时，多次皮肤活检是有用的。
