Intravascular large B-cell lymphoma with isolated bone marrow involvement

Introduction. Intravascular large B-cell lymphoma is a rare variant of B-cell, highly invasive extranodal tumors the lymphatic system. The pathogenesis disease lies in ability tumor cells to penetrate into small vessels and capillaries various organs. clinical presentation atypical for diffuse lymphoma. In relevant literature, information on diagnosis treatment this pathology extremely rare, therefore each publication makes significant contribution expanding horizons hematologists morphologists. Aim – present case diagnosing intravascular Main findings. A 78-year-old patient who fell ill acutely presented. At onset disease, febrile fever was noted. general blood test: hemoglobin 10 4 g/L; erythrocytes 3.0 × 12 /L; ESR 24 mm/h; platelets 112 9 /L, leukocytes 4.9 % with lymphoblast morphology were found leukocyte formula. Blood serum tests revealed: an increase uric acid concentrations up 639 μmol/L, LDH 1885 U/L, beta-2-microglobulin 8.9 mmol/L, C-reactive protein 0.6 g/L, decrease concentration total 45 aspartate aminotransferase 48 units/L at normal bilirubin alanine aminotransferase. histological immunohistochemical picture, according study bone biopsy, most corresponded marrow damage by Immunophenotyping carried out 15.7 blast immunophenotype CD19 + HLA/DR CD24 CD37 CD20 CD10 IgM detected. Cytogenetic studies revealed no karyotype abnormalities. result fluorescence situ hybridization IGH locus (14q32) normal. Based data obtained, final established: lymphoma, stage IVB, involvement, aggressive course. prescribed first line therapy R-CHOP scheme (rituximab, cyclophosphamide, vincristine, prednisolone). control marrow, after course therapy, number lymphoid elements 3.6 %, laboratory parameters returned