Bone marrowliverspleen type of large bcell lymphoma associated with hemophagocytic syndrome. Characteristics of intravascular large bcell lymphoma on. Asianvariant intravascular lymphoma in the african race. The precise classification of this disorder or variant is not clear as apparently not all cases of asian diffuse large bcell lymphoma with haemophagocytic syndrome exhibit intravascular features intravascular histiocytosis variant. Hs has been reported mainly in asia and is regarded as a distinct. Presentation and management of intravascular large bcell. The asian variant of intravascular lymphoma aivl is a rare nonhodgkins lymphoma, characterized by hemophagocytic syndrome and the absence of neurological abnormality or skin lesions, which are.
Intravascular lymphoma is also known as intravascular large bcell lymphoma, intravascular lymphomatosis, angiotropic large cell lymphoma, and malignant angioendotheliomatosis. A rare subtype of dlbcl characterised by the presence of lymphoma cells only within the lumina of small vessels synonyms. Central nervous system involvement in intravascular large b. Intravascular large bcell lymphoma ivlbcl is a rare disease entity of nonhodgkin lymphoma according to the current who classification. Dec 12, 2009 intravascular large bcell lymphoma ivlbcl is a rare subtype of nonhodgkin lymphoma characterized by the presence of lymphoma cells only in the lumina vessels. Intravascular large bcell lymphoma ivlbcl is a rare subtype of extranodal diffuse large bcell lymphoma dlbcl, as classified by who. Intravascular lymphomatosis ivl is a rare intravascular subtype of extranodal large cell lymphoma causing multifocal vascular occlusion and resulting in diffuse thrombosis, a high incidence of neurological and cutaneous involvement. Intravascular large bcell lymphoma and other intravascular lymphomatoses ivls, including ivl with bcell phenotype and extravascular growth bivl and ivl with tcell phenotype tivl, were compared in a series of cases diagnosed at a single institution and in cases reported in the literature. Intravascular lymphoma definition of intravascular lymphoma. Intravascular large bcell lymphoma ivl is an extremely rare malignancy, mainly studied through european and asian series. The classical and hemophagocytic variants are present mainly in western or asian countries, respectively, although exceptions have been. Intravascular large bcell lymphoma with a fulminant clinical. Since 2001, the intravascular large bcell lymphoma ivlbcl has been recognized as an entity in the who classification. Asian variant of intravascular large bcell lymphoma.
The disease is rare, and information for its exact frequency among nonhodgkin lymphoma nhl has been extremely limited. Intravascular lymphoma ivl, also known as intravascular lymphomatosis, corresponds to a rare variant of extranodal diffuse large b cell lymphoma that affects small and medium sized vessels, and has no specific clinical or laboratory findings. To evaluate cns involvement, particularly recurrence. It develops slightly more often in men than in women. Asian variant of intravascular large b cell lymphoma causes.
Hemophagocytosisrelated asian variant intravascular large b. We report a case of intravascular bcell lymphoma in a caucasian patient associated with secondary hemophagocytic syndrome. Intravascular large bcell lymphoma ivlbcl with hemophagocytic lymphohistiocytosis hlh is a rare entity that is typically seen in the asian variant of the condition. Apr 11, 2011 intravascular large bcell lymphoma bivl is listed as a distinct disease entity in the world health organizationwho classification for lymphoid neoplasms. Intravascular large bcell lymphoma as mononeuritis multiplex.
Asianvariant intravascular large bcell lymphoma ncbi. Silent intravascular lymphoma initially manifesting as a. There are limited data about the influence of the central nervous system cns involvement on the prognosis for patients with the asian variant of intravascular large bcell. First described as angioendotheliomatosis proliferans systemisata by pfleger and tappeiner 1 in 1959, intravascular angiotropic lymphoma ivl is a rare variant of large cell lymphoma characterized by proliferation of neoplastic lymphoid cells within small blood vessels. In western countries, a cutaneous variant of ivlbcl, which only involves single or multiple lesions of the skin without systemic involvement, was recently proposed. Definition, diagnosis, and management of intravascular large b. Download citation an asian variant of intravascular large b. Intravascular large bcell lymphoma, hemophagocytic syndromeassociated variant presentation.
Pdf asian variant of intravascular large bcell lymphoma. Intravascular large bcell lymphoma immunohistochemistry. As a diagnosis of intravascular lymphoma can be difficult, it is often only diagnosed on autopsy. We report a case of hemophagocytosisrelated asian variant intravascular large bcell lymphoma ivlbcl in a patient of western origin initially diagnosed by splenectomy with diffuse large bcell lymphoma dlbcl with a micronodular pattern. The classical and hemophagocytic variants are present mainly in western or asian countries, respectively, although exceptions have been increasingly reported in. Intravascular large bcell lymphoma ilcl may also be called intravascular angiotropic lymphoma. Its previous name, intravascular large bcell lymphoma, asian variant, was recently changed to its current name by the world health organization, 2016. Oct 16, 2018 intravascular large bcell lymphoma ilbcl is a rare, bcell nonhodgkins lymphoma. Intravascular nkcell lymphoma ivnkl is an extremely rare variant of nonhodgkin lymphoma. Pathology of intravascular large bcell lymphoma dr.
Intravascular lymphoma has a strong association with hemophagocytic syndrome in asian patients, the socalled asian variant, but not in western patients. Intravascular large bcell lymphoma canadian cancer society. Hemophagocytosisrelated asian variant intravascular. A case of intravascular large bcell lymphoma of the. Intravascular large bcell lymphoma how is intravascular. Autopsy identified widespread cd20 positive intravascular large bcell lymphoma with significant hepatosplenic involvement, characteristic of the asian variant ivlbcl. Aug 28, 2019 murase t, nakamura s, kawauchi k, et al. Presentation and management of intravascular large bcell lymphoma kazuyuki shimada, tomohiro kinoshita, tomoki naoe, shigeo nakamura intravascular large bcell lymphoma ivlbcl is a rare disease entity of nonhodgkin lymphoma according to the current who classi. Intravascular large bcell lymphoma american society of hematology. Intravascular large bcell lymphoma associated with systemic. Due to the low incidence of this condition, our understanding of the clinical presentation as well as the management of ivl relies on a limited number of patients.
The final diagnosis was intravascular large bcell lymphoma, presented as mononeuritis multiplex. We report a case of hemophagocytosisrelated asian variant intravascular large bcell lymphoma ivlbcl in a patient of western origin initially diagnosed by splenectomy with diffuse. Strange characteristics of ivlbcl, including the absence of marked lymphoadenopathy and the usually aggressive clinical. The clonal relationship between these two dlbcl subtypes is also investigated.
Rajan jain, shehanaz ellika, in handbook of neurooncology neuroimaging, 2008. Intravascular lymphoma usually shows rapid progression and short survival, with at best. The condition is usually systemic and can affect the brain. Frequency of intravascular large bcell lymphoma in japan. Ilcl usually occurs in middleaged or elderly people. Objective the asian variant of intravascular lymphoma aivl is a rare nonhodgkins lymphoma, characterized by hemophagocytic syndrome and the absence of neurological abnormality or skin lesions, which are typical features of classical ivl. Intravascular lymphoma radiology reference article. Pdf asianvariant intravascular lymphoma in the african race. Definition, diagnosis, and management of intravascular large. We report a case of hemophagocytosisrelated asian variant intravascular large bcell lymphoma ivlbcl in a patient of.
Pathology outlines intravascular large b cell lymphoma. The skin changes and neurological symptoms are more frequent in the conventional type of intravascular large bcell lymphoma but are not rare in the asian variant. Intravascular large bcell lymphoma ivlbcl is a rare form of diffuse lbcl. Within the entity of intravascular large bcell lymphoma are the classical, visceral form of the disease also referred to as the western form of intravascular large bcell lymphoma, a cutaneous variant, and an asian variant, each with distinct distribution of disease and different clinical manifestations table 141. We present here that the syndrome of inappropriate antidiuretic hormone secretion frequently occurs in patients with the asian variant of intravascular. She met a sufficient number of diagnostic criteria outlined in the hlh2004 trial including. Intravascular large bcell lymphoma ilbcl, also referred to as angiotropic largecell lymphoma. Ivl is a rare subtype of extranodal diffuse large bcell lymphoma.
The asian variant of intravascular large b cell lymphoma is a special type of intravascular lymphoma with hemophagocytic syndrome and hypercytokinemia including interleukin6, which stimulates antidiuretic hormone synthesis in the hypothalamus. Mesa, asian variant intravascular lymphoma in the african race, rare tumors, vol. The purpose of this study was to describe the characteristics and out. A type of diffuse large b cell lymphoma with intravascular growth in skin, cns, other sites. This case uniquely highlights development of the asian variant ivlbvl in a previously undescribed race. Intravascular lymphoma an overview sciencedirect topics. It displays some differences in clinical presentation. Intravascular lymphoma is characterized by nearly exclusive intravascular neoplastic proliferation of b lymphocytes, usually without involvement of lymphoid tissues and peripheral blood.
Sep 21, 2016 intravascular large bcell lymphoma ivlbcl is a rare form of diffuse lbcl characterized by preferential intravascular growth of malignant lymphocytes, aggressive behavior, and an often fatal course. Intravascular large bcell lymphoma is an important cause of fever of unknown origin and multiple organ failure. Jan 02, 2012 autopsy identified widespread cd20 positive intravascular large bcell lymphoma with significant hepatosplenic involvement, characteristic of the asian variant ivlbcl. Episodic fevers and worsening anemia are thought to be related to episodes of hemophagocytic lymphohistiocytosis hlh triggered by her underlying lymphoma. It is yet unclear whether the two phenotypic variants of intravascular large cell lymphoma, namely, the more frequent bcell type and the exceedingly rare natural killer nktcell type, represent different phenotypes of one category of lymphoma or completely different entities. Intravascular large bcell lymphoma ivlbcl is a rare form of an extranodal malignant nonhodgkin lymphoma nhl that. This rare form of bcell lymphoma is characterised by selective growth of tumour cells in the lumina of small vessels of various organs. Ivlbcl usually affects elderly patients with poor performance status, elevated lactic dehydrogenase serum levels, anemia, and b symptoms. Intravascular large bcell lymphoma cancer therapy advisor. Intravascular lymphomas ivl are rare cancers in which malignant lymphocytes proliferate and. Intravascular large bcell lymphoma stanford university.
Malignancyassociated hlh represents up to onefourth of. Intravascular large cell lymphomas plastic surgery key. Its previous name, intravascular large bcell lymphoma, asian variant, was recently changed to its current name by the world health. Intravascular large bcell lymphoma with hemophagocytic. An asian variant of intravascular large bcell lymphoma. It is a very rare, fastgrowing aggressive subtype of diffuse large bcell lymphoma dlbcl. The exclusively intravascular localization of this lymphoma is attributed to a deficient property of extravasation, most probably due to a loss of the two adhesion molecules icam1 cd54 and beta1 integrin cd29. Retrospective analysis of intravascular large bcell lymphoma. The patient was diagnosed by core liver biopsy and successfully. The hemophagocytic syndromeassociated variant of ivbcl is a very rare variant of ivbcl.
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