title: Early diagnosis of recurrent diffuse large B-cell lymphoma showing intravascular lymphoma by random skin biopsy.
abstract: A 66-year-old man was admitted to our hospital presenting 2 weeks' history of fever of unknown origin with elevated levels of lactate dehydrogenase and C-reactive protein. Six years before this episode, he had developed diffuse large B-cell lymphoma, which had been successfully treated with chemoradiation. While recurrence of diffuse large B-cell lymphoma was suspected, there was neither lymphadenopathy nor tumor formation by the imaging study. Random biopsy from normal-appearing abdominal skin showed extensive infiltration of CD20(+), CD79a(+), CD3(-) atypical lymphoid cells in the lumen of vessels in subcutaneous tissues. These findings led us to the diagnosis of intravascular B-cell lymphoma. Following rituximab plus cyclophosphamide, adriamycin, vincristine and prednisolone therapy, high fever subsided, and lactate dehydrogenase and C-reactive protein levels returned to the normal range. In conclusion, random skin biopsy is useful for the early diagnosis of intravascular B-cell lymphoma.
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan. casuaki@hama-med.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Kasuya
authors.forename: Hideo
authors.initials: H
authors.lastname: Hashizume
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takigawa
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001706:Biopsy; D001808:Blood Vessels / Q000473:pathology; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000175:diagnosis* / Q000188:drug therapy; D012867:Skin / Q000098:blood supply / Q000473:pathology; D012878:Skin Neoplasms / Q000098:blood supply* / Q000175:diagnosis* / Q000188:drug therapy; D013997:Time Factors