皮膚ランダム生検が診断に有用であった血管内リンパ腫の一例

A６２‐year‐old woman was referred to our hospital for further examination of fever of unknown origin, splenomegaly and pancytopenia. On admission, she had persistent fever and psychological symptoms. Blood examination showed pancytopenia and elevated level of LDH, soluble IL‐２receptor and ferritin. Computed tomography showed multiple low density areas in the spleen, but no systemic lymphadenopathy. In magnetic resonance imaging of the pons, a low and high intensity area on T１‐and T２‐weighted image, respectively, was detected. Taken together these findings, she was suspected to have hepatosplentic T-cell lymphoma or intravascular large B-cell lymphoma. To make a definite diagnosis, random skin biopsy was performed. Immunohistochemical stainings revealed the massive infiltration of CD２０‐and CD７９α‐positive large lymphoid cells inside the vessels, which yielded the diagnosis of intravascular large B-cell lymphoma.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html