title: Hemophagocytosis-Related (Asian Variant) Intravascular Large B-Cell Lymphoma in a Hispanic Patient:  A Case Report Highlighting a Micronodular Pattern in the Spleen.
abstract: OBJECTIVE
  We report a case of hemophagocytosis-related (Asian variant) intravascular large B-cell lymphoma (IVLBCL) in a patient of Western origin initially diagnosed by splenectomy with diffuse large B-cell lymphoma (DLBCL) with a micronodular pattern. The clonal relationship between these two DLBCL subtypes is also investigated.
  
  
  METHODS
  Hemophagocytosis-related (Asian variant) IVLBCL was identified at autopsy in a 62-year-old Hispanic woman, in North America, following an antemortem diagnosis of massive splenic involvement by DLBCL with a micronodular pattern, a feature not expected of IVLBCL.
  
  
  RESULTS
  These two apparently distinct lymphoma types demonstrated similar immunophenotypic profiles and IgH gene rearrangements of identical size suggesting a clonal relationship. The 2008 WHO classification system describes IVLBCL in the spleen as having a sinusoidal pattern.
  
  
  CONCLUSIONS
  Our observations provide the first molecular genetic support for a seemingly underrecognized micronodular pattern of IVLBCL in the spleen and further support the proposal of a "mixed variant" of IVLBCL with concomitant "intravascular" and "solid" phases of disease.
authors.affiliation: From the San Antonio Military Medical Center, Fort Sam Houston, TX;
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Hall
authors.affiliation: Madigan Army Medical Center, Tacoma, WA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Meyers
authors.affiliation: Madigan Army Medical Center, Tacoma, WA.
authors.forename: Jared
authors.initials: J
authors.lastname: Andrews
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D008875:Middle Aged; D013154:Spleen / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: Hematology; Hematopathology; Intravascular large B-cell lymphoma