Intravascular Lymphomatosis Initially Suspected from Uterine Cytology
| Autor: | Jun Ishiko, Jun-ichiro Ikeda, Masao Mizuki, Katsuyuki Aozasa, Kouki Shimazu, Yuzuru Kanakura, Itsuko Nakamichi, Amane Yamauchi |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Pathology Histology medicine.diagnostic_test business.industry Uterus Large-cell lymphoma Hepatosplenomegaly Anatomical pathology General Medicine medicine.disease Pathology and Forensic Medicine Lymphoma medicine.anatomical_structure Cytology Biopsy Medicine Immunohistochemistry medicine.symptom business |
| Zdroj: | Acta Cytologica. 53:198-200 |
| ISSN: | 1938-2650 0001-5547 |
| DOI: | 10.1159/000325125 |
| Popis: | Background Because recognizable lesions are often absent, selection of biopsy sites for diagnosis of intravascular large B-cell lymphoma (IVL) is frequently problematic. Case A 59-year-old woman was admitted with fever and general fatigue. Combined physical and roentgenographic examinations revealed neither lymphadenopathy, hepatosplenomegaly nor mass lesions in other organs. Serum lactate dehydrogenase level was 1412 IU/L. There were no genital symptoms, but uterine cytologic examination revealed large cells distributed in a noncohesive pattern. These cells had a large, irregularly shaped nucleus in which several nucleoli were discernible and showed positive immunoreactivity for leukocyte common antigen. Three months after admission, neurologic symptoms appeared, and magnetic resonance imaging revealed multiple nodular lesions in the brain. Biopsy specimens from the brain lesion showed the proliferation of large lymphoid cells filling the lumina of small vessels and Virchow-Robin's space. Immunohistochemistry revealed that the tumor cells were positive for CD20 and CD79a but negative for CD3, indicative of IVL. Conclusion Uterine cytologic and/or histologic examinations could be the choice for diagnosis of IVL, even when genital symptoms are absent. |
| Databáze: | OpenAIRE |
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