Key result
Intravascular large B-cell lymphoma can mimic hypersensitivity pneumonitis and temporarily regress, delaying diagnosis.
Why the study?
Intravascular large B-cell lymphoma is a rare and often fatal malignancy presenting with non-specific pulmonary symptoms and abnormal imaging findings.
Intravascular large B-cell lymphoma can mimic hypersensitivity pneumonitis and exhibit temporary spontaneous regression, emphasizing the need for tissue biopsy when clinical improvement is not sustained.
IVLBCL should be considered in apparent hypersensitivity pneumonitis; extends known mimics and supports early cryobiopsy.
Intravascular large B-cell lymphoma (IVLBCL) is a rare and often fatal malignancy that presents with non-specific pulmonary symptoms and abnormal imaging findings. We report a unique case of IVLBCL in a 73-year-old man who initially presented with fever and bilateral ground-glass opacities on computed tomography that mimicked hypersensitivity pneumonitis. The symptoms temporarily improved with environmental antigen avoidance, which delayed a correct diagnosis. Ultimately, transbronchial lung cryobiopsy confirmed IVLBCL, and chemotherapy was effective. This case highlights the potential for spontaneous regression of IVLBCL and the importance of considering malignancy when clinical improvement is not sustained.
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Ozawa et al. (2026) studied this question. Intravascular large B-cell lymphoma can mimic hypersensitivity pneumonitis and exhibit temporary spontaneous regression, delaying diagnosis if malignancy is not considered.
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