A Case of Intravascular Large B-cell Lymphoma (IVLBCL) with no Abnormal Findings on Chest Computed Tomography Diagnosed by Random Transbronchial Lung Biopsy

作者：Kaku Norihito; Seki Masafumi^*; Doi Seiji; Hayashi Tomayoshi; Imanishi Daisuke; Imamura Yoshifumi; Kurihara Shintaro; Miyazaki Taiga; Izumikawa Koichi; Kakeya Hiroshi; Yamamoto Yoshihiro; Yanagihara Katsunori; Tashiro Takayoshi; Kohno Shigeru

来源：Internal Medicine, 2010, 49(24): 2697-2701.

DOI：10.2169/internalmedicine.49.3986

• autoimmune hemolytic anemia (AIHA)
• computed tomography
• fever of unknown origin (FUO)
• intravascular large B-cell lymphoma (IVLBCL)
• rituximab
• transbronchial lung biopsy (TBLB)

A 58-year-old woman was admitted with refractory fever despite receiving broad-spectrum antibiotics. She had hypoxemia, severe anemia, elevated levels of serum lactic dehydrogenase and soluble interleukin-2 receptor, and a positive direct Coombs test, which suggested an underlying autoimmune hemolytic anemia (AIHA). Chest computed tomography (CT) showed no abnormal findings, but she had hypoxia, and her alveolar-arterial oxygen difference (A-aDO(2)) was increased. A random transbronchial lung biopsy (TBLB) was performed, and pathological analysis showed massive proliferation of tumor cells in the lumina of the small vessels. Intravascular large B-cell lymphoma (IVLBCL) was diagnosed, and her general status improved after chemotherapy.

• 出版日期2010