Key result
Mechanical thrombectomy for DVT enables diagnosis of intravascular large B-cell lymphoma, yielding 4-year remission.
Why the study?
Intravascular large B-cell lymphoma often presents with non-specific systemic manifestations, making diagnosis challenging, and thrombotic events are uncommon at initial presentation.
Case Report (n=1)
No
Routine histopathological examination of thrombectomy specimens can incidentally detect rare intravascular malignancies like IVLBCL, enabling early and successful treatment.
Answers are grounded in this paper and cite their sources.
Supports histopathology of DVT thrombectomy specimens for occult lymphoma; single case leaves open routine adoption.
Background and Clinical Significance: Intravascular large B-cell lymphoma (IVLBCL) is an exceedingly rare and aggressive malignancy characterized by the selective growth of lymphoma cells within blood vessel lumina. This malignancy often presents with non-specific systemic manifestations, making diagnosis challenging. Neurological symptoms and cutaneous findings are typical, whereas thrombotic events are uncommon at the initial presentation. We report a unique case of IVLBCL with MYC and BCL2 rearrangements (“double-hit” genetics), diagnosed following mechanical thrombectomy; Case Presentation: A 79-year-old woman presented with acute right-lower-limb swelling due to extensive iliofemoral deep vein thrombosis. Mechanical thrombectomy was performed, and the histopathological and genetic examination of the retrieved material revealed IVLBCL. Subsequent staging with positron emission tomography-computed tomography (PET-CT) demonstrated an FDG-avid tumor thrombus confined to the right internal iliac vein, without any lymphadenopathy or solid tumor mass. The patient was successfully treated with a combination of systemic chemoimmunotherapy and targeted radiotherapy and remained in complete remission for more than four years after diagnosis; Conclusions: We report a potentially unique case of double-hit IVLBCL diagnosed using endovascular thrombectomy. This underscores the therapeutic and diagnostic potential of mechanical thrombectomy systems in the detection of intravascular malignancies and the critical importance of the routine histopathological examination of all thrombectomy specimens. Despite negative thrombolysis data from the ATTRACT and CAVA trials, mechanical thrombectomy may improve venous hemodynamics and may reduce post-thrombotic syndrome (PTS) in pelvic thrombosis. Here, mechanical thrombectomy followed by right iliac vein stenting achieved excellent technical and clinical outcomes.
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Bajrami et al. (2026) conducted a case report in Intravascular large B-cell lymphoma (IVLBCL) presenting as deep vein thrombosis (n=1). Mechanical thrombectomy and histopathological examination was evaluated on Diagnosis and clinical outcome. Mechanical thrombectomy of an iliofemoral deep vein thrombosis led to the incidental diagnosis of a rare double-hit intravascular large B-cell lymphoma, resulting in complete remission for over four years after treatment.
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