Key result
A 58-year-old woman with intravascular large B-cell lymphoma and no abnormal chest CT findings was successfully diagnosed via random transbronchial lung biopsy and improved after R-CHOP chemotherapy.
Case Report (n=1)
Random transbronchial lung biopsy can be a useful diagnostic tool for intravascular large B-cell lymphoma in patients presenting with hypoxemia and increased A-aDO2 despite normal chest CT findings.
May support random transbronchial lung biopsy in unexplained hypoxemia with normal CT; hypothesis-generating and requires prospective validation.
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-aDO2) 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.
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Kaku et al. (2010) conducted a case report in Intravascular Large B-cell Lymphoma (IVLBCL) (n=1). R-CHOP chemotherapy was evaluated on Clinical improvement. A 58-year-old woman with intravascular large B-cell lymphoma and no abnormal chest CT findings was successfully diagnosed via random transbronchial lung biopsy and improved after R-CHOP chemotherapy.
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