Intravascular large B-cell lymphoma (IVLBCL): Subtle Presentation and Challenging Diagnosis

Abstract Introduction/Objective Intravascular large B-cell lymphoma (IVLBCL) is a rare, clinically aggressive defined by the proliferation of atypical cells in lumen all sized blood vessels, particularly capillaries. The reasons for this unusual neoplastic cell are still only partially understood. IVLBCL considered stage IV and manifests with variety nonspecific signs symptoms. Patients usually do not present lymphadenopathy. tumor invade vessels multiple organs such as central nervous system, skin, lungs, kidneys, bone marrow. Common presenting symptoms based on organ affected include mental status changes fever unknown origin. Although immunochemotherapy has significantly improved often-poor prognosis kind lymphoma, percentage patients relapse. Methods/Case Report We 63-year-old man who had been diagnosed diffuse B marrow March 2021 was remission state after completing six cycles chemotherapy. There no abnormal FDG uptake post-chemotherapy PET/CT scan. Patient presented to ER two months later dyspnea. entire workup completed showed pancytopenia elevated ESR. While chest CT scan did show lymphadenopathy or lesions, scans revealed widespread increase both lungs spleen. Lung biopsy within alveolar septae vessels. Immunohistochemical stains demonstrated that these were positive CD20 PAX-5 high rate Ki67. Results (if Case Study enter NA) NA Conclusion low incidence non-specific clinical presentation. diagnosis can be easily missed clinical, radiological corresponding histopathological findings . Radiological finding sensitive enough may miss lesion. Even though more sensitive, definitive relies mainly histopathology immunohistochemistry, at which point awareness entity Pathologist most necessary.