Background: The use of random skin biopsy (RSB) to diagnose intravascular large B cell lymphoma (IVLBCL) has increased. Objective: To explore the indication for RSB to diagnose IVLBCL. Methods: We retrospectively evaluated the medical records of 18 Japanese adults who underwent RSB between January 2008 and December 2009. Results: A final diagnosis of IVLBCL was returned in 2 patients based on RSB findings and in 1 based on brain biopsy findings. All 3 patients manifested neurological symptoms, hematocytopenia, elevated levels of LDH and soluble interleukin-2 receptor (sIL-2R), and the absence of lymphadenopathy. Malignant lymphoma other than IVLBCL was diagnosed in 6 patients, and in 5 of 6 patients who underwent nodal or parenchymal biopsy diagnostic findings were made. Conclusion: Although RSB is useful for the early diagnosis of IVLBCL, careful selection of patients is necessary. In patients with neurological symptoms, hematocytopenia, elevated LDH and sIL-2R and no nodal involvement, RSB may be useful.

Keywords:
Random skin biopsy, Intravascular large B cell lymphoma, Lymphadenopathy
1.
Shimada K, Kinoshita T, Naoe T, Nakamura S: Presentation and management of intravascular large B-cell lymphoma. Lancet Oncol 2009;10:895–902.
2.
Gill S, Melosky B, Haley L, ChanYan C: Use of random skin biopsy to diagnose intravascular lymphoma presenting as fever of unknown origin. Am J Med 2003;114:56–58.
3.
Le EN, Gerstenblith MR, Gelber AC, Manno RL, Ranasinghe PD, Sweren RJ, McGirt LY: The use of blind skin biopsy in the diagnosis of intravascular B-cell lymphoma. J Am Acad Dermatol 2008;59:148–151.
4.
Asada N, Odawara J, Kimura S, Aoki T, Yamakura M, Takeuchi M, Seki R, Tanaka A, Matsue K: Use of random skin biopsy for diagnosis of intravascular large B-cell lymphoma. Mayo Clin Proc 2007;82:1525–1527.
5.
Matsue K, Asada N, Odawara J, Aoki T, Kimura S, Iwama K, Fujiwara H, Yamakura M, Takeuchi M: Random skin biopsy and bone marrow biopsy for diagnosis of intravascular large B cell lymphoma. Ann Hematol 2011;90:417–421.
6.
Murase T, Nakamura S, Kawauchi K, Matsuzaki H, Sakai C, Inaba T, Nasu K, Tashiro K, Suchi T, Saito H: An Asian variant of intravascular large B-cell lymphoma: clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome. Br J Haematol 2000;111:826–834.
7.
Ferreri AJ, Campo E, Seymour JF, Willemze R, Ilariucci F, Ambrosetti A, Zucca E, Rossi G, López-Guillermo A, Pavlovsky MA, Geerts ML, Candoni A, Lestani M, Asioli S, Milani M, Piris MA, Pileri S, Facchetti F, Cavalli F, Ponzoni M; International Extranodal Lymphoma Study Group (IELSG): Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the ‘cutaneous variant’. Br J Haematol 2004;127:173–183.
8.
Shimada K, Matsue K, Yamamoto K, Murase T, Ichikawa N, Okamoto M, Niitsu N, Kosugi H, Tsukamoto N, Miwa H, Asaoku H, Kikuchi A, Matsumoto M, Saburi Y, Masaki Y, Yamaguchi M, Nakamura S, Naoe T, Kinoshita T: Retrospective analysis of intravascular large B-cell lymphoma treated with rituximab-containing chemotherapy as reported by the IVL study group in Japan. J Clin Oncol 2008;26:3189–3195.
9.
Niida T, Isoda K, Miyazaki K, Kanoh S, Kobayashi H, Kobayashi A, Kimura F, Hayashi K, Kusuhara M, Ohsuzu F: Pulmonary intravascular lymphoma diagnosed by 18-fluorodeoxyglucose positron emission tomography-guided transbronchial lung biopsy in a man with long-term survival: a case report. J Med Case Reports 2011;5:295.
10.
Lee BS, Frankfort BJ, Eberhart CG, Weinberg RS: Diagnosis of intravascular lymphoma by a novel biopsy site. Ophthalmology 2011;118:586–590.
11.
Xu M, Yang Q, Li M, Geng W, Huang W, Chen Y: Prostate involvement of intravascular large B-cell lymphoma: a case report with literature review. Int J Surg Pathol 2011;19:544–547.
12.
Murase T, Yamaguchi M, Suzuki R, Okamoto M, Sato Y, Tamaru J, Kojima M, Miura I, Mori N, Yoshino T, Nakamura S: Intravascular large B-cell lymphoma (IVLBCL): A clinicopathologic study of 96 cases with special reference to the immunophenotypic heterogeneity of CD5. Blood 2007;109:478–485.
13.
Kaku N, Seki M, Doi S, et al: A case of intravascular large B-cell lymphoma (IVLBCL) with no abnormal findings on chest computed tomography diagnosed by random transbronchial lung biopsy. Intern Med 2010;49:2697–2701.
14.
Shimada K, Murase T, Matsue K, et al: Central nervous system involvement in intravascular large B-cell lymphoma: a retrospective analysis of 109 patients. Cancer Sci 2010;101:1480–1486.
15.
Washio K, Nakata K, Nakamura A, Horikawa T: Pressure bandage as an effective treatment for intralymphatic histiocytosis associated with rheumatoid arthritis. Dermatology 2011;223:20–24.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.