Fujioka Haruka, Nakashima Kei, Uesugi Yuka, Nyui Miki, Inoshima Naoki, Hayashi Jun, Yoshimi Michinori, Katsumata Miho, Masuzawa Masahiro, Usami Hayato, Ito Akane, Tabata Rikako, Matsue Kosei
Department of Pulmonology, Kameda Medical Center, Chiba, Japan.
Department of Hematology and Oncology, Kameda Medical Center, Chiba, Japan.
Respir Med Case Rep. 2024 Sep 15;52:102115. doi: 10.1016/j.rmcr.2024.102115. eCollection 2024.
Intravascular large B-cell lymphoma (IVLBCL) typically involves nonspecific symptoms that complicate diagnosis. This report discusses the case of a 70-year-old man, who presented with dyspnea, fatigue, and weight loss that evolved into severe respiratory failure, diagnosed with IVLBCL via random skin biopsy. The initial improvement in respiratory symptoms was followed by coronavirus disease. Response to steroid therapy and elevated lactate dehydrogenase levels suggested IVLBCL, confirmed by a random skin biopsy. The combination chemotherapy of rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone improved the respiratory condition. This case highlights the diagnostic challenges associated with IVLBCL and the crucial role of random skin biopsy.
血管内大B细胞淋巴瘤（IVLBCL）通常表现为非特异性症状，这使得诊断变得复杂。本报告讨论了一名70岁男性的病例，他最初出现呼吸困难、疲劳和体重减轻，随后发展为严重呼吸衰竭，通过随机皮肤活检诊断为IVLBCL。呼吸症状最初有所改善，随后感染了冠状病毒病。对类固醇治疗的反应和乳酸脱氢酶水平升高提示为IVLBCL，随机皮肤活检证实了这一诊断。利妥昔单抗、环磷酰胺、长春新碱、阿霉素和泼尼松龙的联合化疗改善了呼吸状况。该病例突出了IVLBCL相关的诊断挑战以及随机皮肤活检的关键作用。
