title: Intravascular large B-cell lymphoma presenting as acute hemorrhagic cerebral infarct with delirium.
abstract: Intravascular large B-cell lymphoma (IVLBCL) is a cumbersome diagnosis to make in vivo, particularly because of its elusive nature and ability to be a relatively nonspecific 'great mimicker'. Although it frequently has skin manifestations, it often escapes diagnosis due to its angiotrophism and predilection for vessels that are difficult to biopsy (e.g., cerebral vasculature). IVLBCL can involve the vasculature of virtually any organ but typically spares the lymph nodes themselves, and likely due to defects in adhesion molecules, remains stationary in the vessels. Histologically, the malignant lymphocytes are large and mitotically active with prominent nucleoli. Immunohistochemically, the cells stain as B-cells. The disease has an overall poor prognosis. Here we present a case of IVLBCL diagnosed at autopsy that presented as a hemorrhagic frontal lobe infarct, which progressed to delirium.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY 40207, USA. d0hani01@lousville.edu
authors.forename: Diana M
authors.initials: DM
authors.lastname: Haninger
authors.forename: Troy A
authors.initials: TA
authors.lastname: Davis
authors.forename: John R
authors.initials: JR
authors.lastname: Parker
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Slone
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Parker
mesh_terms: D000208:Acute Disease; D000368:Aged; D001344:Autopsy; D001706:Biopsy; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000175:diagnosis*; D003693:Delirium / Q000175:diagnosis*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis*; D019043:Vascular Neoplasms / Q000175:diagnosis*