Use of Random Skin Biopsy for Diagnosis of Intravascular Large B-Cell Lymphoma

Noboru Asada, Jun Odawara, Shun ichi Kimura, Takatoshi Aoki, Masayuki Yamakura, Masami Takeuchi, Reiko Seki, Atsushi Tanaka, Kosei Matsue

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Intravascular lymphoma (IVL) is a rare type of extranodal lymphoma with an aggressive clinical course characterized by proliferation of large lymphoma cells within the lumina of the small vessels. Because of its varied clinical symptoms and the absence of lymphadenopathy, diagnosis of IVL is extremely difficult and requires histological confirmation. We report here 6 consecutive patients with IVL, admitted to Kameda General Hospital, Kamogawa-shi, Japan, from June 7, 2006, to February 28, 2007, whose IVL was diagnosed by random skin biopsy of healthy-appearing skin. Three patients presented with progressive neurological deterioration and 2 others with hypoxemia with interstitial infiltration on chest radiography. One patient presented with confusion and severe hypoxia without apparent interstitial infiltration. Two patients showed localized skin involvement. Irrespective of the presence of skin lesions, almost all skin biopsy specimens showed obliteration of small vessels of subcutaneous fat tissues by lymphoma cells, allowing a prompt diagnosis of IVL. Early institution of rituximab-based chemotherapy induced favorable responses in all patients treated. Because diagnosis based on tissue other than skin is usually difficult in patients with suspected IVL, random skin biopsy should be considered even in patients with no evident skin lesions.

Original languageEnglish
Pages (from-to)1525-1527
Number of pages3
JournalMayo Clinic Proceedings
Issue number12
Publication statusPublished - Dec 2007
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Medicine


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