Why the study?
Intravascular large B-cell lymphoma typically grows selectively within small vessels, and cases characterized by proliferation within large blood vessels had not been reported.
Intravascular large B-cell lymphoma can atypically involve large blood vessels, potentially causing sudden death from tumor emboli.
IVLBCL may involve large vessels; leaves open whether this variant alters diagnosis or outcomes.
Although intravascular large B-cell lymphoma (IVLBCL) is an extranodal lymphoma characterized by the selective growth of lymphoma cells within the lumina of small vessels, we here report three autopsy cases of IVLBCL characterized by the proliferation within large blood vessels. These three cases were diagnosed as IVLBCL of the bone marrow or skin biopsy. Two cases died suddenly before treatment, whereas the other died during treatment. Autopsies showed a large embolus of dense lymphoma cells extending from the truncus pulmonalis to the pulmonary arteries in Case 1, emboli of lymphoma cells in the aorta and carotis in Case 2, and a mass of lymphoma cells blocking the lumen of the aortic arch in Case 3. This is the first report of IVLBCL involving large blood vessels, and it is essential to note that this type of IVLBCL might cause sudden death because of tumor emboli within large blood vessels.
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Sato et al. (2019) studied this question.
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