Suzuki Michiko, Yashima-Abo Akiko, Ehara Shigeru, Ito Shigeki, Satoh Takashi
Department of Radiology, Iwate Medical University School of Medicine, Iwate, Japan.
Division of Biomedical Research and Development, Iwate Medical University Institute for Biomedical Sciences, Iwate, Japan.
J Clin Exp Hematop. 2025 Jun 28;65(2):115-120. doi: 10.3960/jslrt.24072. Epub 2025 Apr 30.
A 65-year-old man presented with painful swelling and thickening of both lower limbs, initially responding to oral steroid treatment. However, the patient later developed similar symptoms, accompanied by general malaise. No abnormalities were detected upon fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. Magnetic resonance imaging (MRI) showed extensive fascial edema in the thigh and gluteal regions, mimicking fasciitis. Concurrently, a bone marrow biopsy revealed intravascular large B-cell lymphoma (IVLBCL), a rare lymphoma with a generally poor prognosis. This case highlights the significance of fasciitis-like MRI findings in diagnosing IVLBCL, underscoring the need for integrating imaging and histological evaluations in atypical presentations.
一名65岁男性出现双下肢疼痛性肿胀和增厚，最初对口服类固醇治疗有反应。然而，患者后来出现类似症状，并伴有全身不适。氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描未发现异常。磁共振成像（MRI）显示大腿和臀部区域广泛的筋膜水肿，类似筋膜炎。同时，骨髓活检显示为血管内大B细胞淋巴瘤（IVLBCL），这是一种罕见的淋巴瘤，预后通常较差。该病例强调了类似筋膜炎的MRI表现对诊断IVLBCL的重要性，突出了在非典型表现中整合影像学和组织学评估的必要性。
