Intravascular lymphomatosis mimicking primary central nervous system lymphoma: a case report and literature review.
We herein report a 75-year-old female patient with intravascular lymphomatosis (IVL) who presented with fever of unknown origin. Examination, including contrast-enhanced CT and (67)Ga scintigraphy, failed to show any lesions. Her blood levels of lactate dehydrogenase and soluble interleukin-2 receptors were high, suggesting a lymphomatous tumor. A bone marrow puncture was negative, and a random skin biopsy revealed a monoclonal proliferation of naked, large lymphocytes in the vascular space of the subcutaneous tissue, confirming the diagnosis of IVL. MRI, performed 7 weeks after admission, showed a brain mass mimicking primary central nervous system lymphoma. The mass was considered to be a collection of malignant lymphocyte cells invading from the vessels. Without the random skin biopsy, this case may have been misdiagnosed as primary central nervous system lymphoma.
Department of Neurology, Nagoya City East Medical Center, Nagoya, Japan.
Masahiro
M
Oomura
Department of Dermatology, Nagoya City East Medical Center, Nagoya, Japan.
Noriyuki
N
Sakakibara
Department of Pathology, Nagoya City East Medical Center, Nagoya, Japan.
Shugo
S
Suzuki
Department of Hematology, Nagoya City East Medical Center, Nagoya, Japan.
Atsushi
A
Wakita
Department of Radiology, Nagoya City East Medical Center, Nagoya, Japan.
Yuji
Y
Mori
Department of Neurology, Nagoya City East Medical Center, Nagoya, Japan.
Kaoru
K
Kamimoto
Brain mass; Diffusion-weighted image; Fever of unknown origin; Intravascular large B-cell lymphoma; Random skin biopsy