Intravascular lymphoma presenting with bone marrow involvement and leukemic phase.
We describe the case of a 62-year-old man with recent onset of constitutional symptoms and vague intellectual deficit. The blood showed pancytopenia with blastemia, and bone marrow confirmed an extensive "vacuolated blast-like cell" infiltrate. Initial diagnosis of, and treatment for Burkitt's leukemia/lymphoma was questioned when the "blasts" typed as CD5+ mature B-cells; however, it was revised to intravascular lymphoma (IVL) only after the sinusoidal pattern was confirmed by immunocytochemistry. Literature review indicated that blood and bone marrow involvement in IVL appears to be rare, but a systematic search for this involvement is often not carried out. CD5 expression has been increasingly reported in this disease. The actual frequency and the significance of this expression are still to be defined.
Khoury
Haytham
H
Leukemia/BMT Program of British Columbia, Vancouver General Hospital and Health Sciences Center, Vancouver, Canada. khaytham@uhnres.utoronto.ca
Dalal
Bakul I
BI
Nantel
Stephen H
SH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001707:Biopsy, Needle; D001854:Bone Marrow Cells / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007621:Karyotyping; D007938:Leukemia / Q000473:pathology*; D008223:Lymphoma / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D017384:Sequence Deletion; D019043:Vascular Neoplasms / Q000188:drug therapy / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone