title: A case of intravascular large B-cell lymphoma (IVLBCL) with no abnormal findings on chest computed tomography diagnosed by random transbronchial lung biopsy.
abstract: A 58-year-old woman was admitted with refractory fever despite receiving broad-spectrum antibiotics. She had hypoxemia, severe anemia, elevated levels of serum lactic dehydrogenase and soluble interleukin-2 receptor, and a positive direct Coombs test, which suggested an underlying autoimmune hemolytic anemia (AIHA). Chest computed tomography (CT) showed no abnormal findings, but she had hypoxia, and her alveolar-arterial oxygen difference (A-aDO2) was increased. A random transbronchial lung biopsy (TBLB) was performed, and pathological analysis showed massive proliferation of tumor cells in the lumina of the small vessels. Intravascular large B-cell lymphoma (IVLBCL) was diagnosed, and her general status improved after chemotherapy.
authors.affiliation: The Second Department of Internal Medicine, Nagasaki University Hospital, and Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki.
authors.forename: Norihito
authors.initials: N
authors.lastname: Kaku
authors.forename: Masafumi
authors.initials: M
authors.lastname: Seki
authors.forename: Seiji
authors.initials: S
authors.lastname: Doi
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kurihara
authors.forename: Taiga
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakeya
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tashiro
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D001706:Biopsy; D001999:Bronchoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods