Intravascular lymphomatosis of the brain. Report of a case using an intraoperative cytologic preparation.
BACKGROUND
Intravascular lymphomatosis (IVL) of the brain is a rare non-Hodgkin's lymphoma characterized by proliferation of tumor cells in the lumina of blood vessels. Although an intraoperative cytologic examination of the brain is routinely done, the cytologic features of IVL are rarely encountered by pathologists. We report a case of IVL diagnosed by an intraoperative cytology preparation.


METHODS
A 62-year-old woman presented with a seizure and fever. Computed tomography and magnetic resonance imaging of the brain were insufficient to establish a diagnosis but suggested a cerebral infarction, so a stereotactic brain biopsy was performed. On an intraoperative cytologic examination, a few small and medium-sized vessels were filled with tumor cells showing atypical, pleomorphic, large nuclei. Immunohistochemical staining using paraffin-embedded tissue revealed intraluminal tumor cells expressing leukocyte common antigen and CD20 but not CD3.


CONCLUSIONS
This disease must be considered one of the diagnostic possibilities in any patient with rapidly progressive dementia and cerebral infarction. Increased awareness of this disease and intraoperative early diagnosis are important for its successful management.
Han
Jae Ho
JH
Department of Pathology, Ajou University School of Medicine, #5 San, Wonchon-Dong, Paldal-Gu, Suwon, South Korea, 442-749. hanpathol@yahoo.co.kr
Kim
Jang Hee
JH
Yim
Hyunee
H
D018951:Antigens, CD20 / Q000378:metabolism; D001706:Biopsy; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007430:Intraoperative Care; D017493:Leukocyte Common Antigens / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011859:Radiography; D013048:Specimen Handling; D013238:Stereotaxic Techniques; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000473:pathology
D018951:Antigens, CD20; D017493:Leukocyte Common Antigens