Yoshino Yuta, Shigeta Shiori
Internal Medicine, Saitama Citizens Medical Center, Saitama, JPN.
Cureus. 2024 Dec 13;16(12):e75658. doi: 10.7759/cureus.75658. eCollection 2024 Dec.
Intravascular large B-cell lymphoma (IVLBCL) is characterized by clinical presentations described as B symptoms, consisting of fever, night sweats, and weight loss. Intravascular lymphomas are more frequently diagnosed in elderly patients and are challenging to diagnose because of their nonspecific clinical presentation. Malignant lymphomas are recognized as the leading cause of fever of unknown origin. Although random skin biopsy is useful for diagnosing intravascular lymphomas, no standardized method for random skin biopsy has been established. Methods to avoid unnecessary skin biopsies and improve diagnostic accuracy have been investigated previously. Here, we report a case of a man in his seventies with intravascular large B-cell lymphoma diagnosed by skin biopsy targeting senile hemangiomas. The combination of random skin and targeted biopsies of skin lesions such as senile hemangiomas may help avoid the diagnostic invasiveness caused by unnecessary biopsies and improve the diagnostic accuracy for intravascular lymphomas.
血管内大B细胞淋巴瘤(IVLBCL)的临床表现以B症状为特征,包括发热、盗汗和体重减轻。血管内淋巴瘤在老年患者中更常被诊断出来,由于其临床表现不具特异性,诊断具有挑战性。恶性淋巴瘤被认为是不明原因发热的主要原因。尽管随机皮肤活检对诊断血管内淋巴瘤有用,但尚未建立标准化的随机皮肤活检方法。此前已对避免不必要的皮肤活检并提高诊断准确性的方法进行了研究。在此,我们报告一例七十多岁男性血管内大B细胞淋巴瘤病例,该病例通过针对老年性血管瘤的皮肤活检得以诊断。随机皮肤活检与针对老年性血管瘤等皮肤病变的靶向活检相结合,可能有助于避免不必要活检导致的诊断侵入性,并提高血管内淋巴瘤的诊断准确性。