PDF(Pubmed)
Abstract：
We report a case of intravascular large B-cell lymphoma (IVL) with spinal cord involvement. A 76-year-old woman was referred to our department due to generalized edema and weight gain. She also had difficulty moving her legs. She had no superficial lymphadenopathy upon examination. Her laboratory tests showed a markedly elevated blood lactate dehydrogenase (LDH) level. Although heart failure or interstitial lung disease was initially suspected, she was diagnosed with IVL by skin biopsy. An MRI revealed spinal cord involvement. Post-hospitalization, she began rituximab-combined chemotherapy. In this case, we considered that the spinal cord involvement of the lymphoma caused the neurogenic bladder and leg weakness. IVL often infiltrates the central nervous system and presents with neurological symptoms, including neurogenic bladder. Therefore, imaging studies should be planned to search for the involvement of the central nervous system in lymphoma if accompanied by neurological symptoms. In addition, in patients with a markedly elevated LDH or soluble interleukin-2 receptor level without lymphadenopathy, IVL should be suspected, and consultation with hematologists should be considered.
摘要：
我们报告了一例脊髓受累的血管内大B细胞淋巴瘤（IVL）。一名76岁的妇女由于全身水肿和体重增加而被转诊到我们部门。她也有困难移动她的腿。经检查，她没有浅表淋巴结肿大。她的实验室检查显示血液乳酸脱氢酶（LDH）水平显着升高。尽管最初怀疑心力衰竭或间质性肺病，她通过皮肤活检被诊断为IVL。MRI显示脊髓受累。住院后，她开始了利妥昔单抗联合化疗.在这种情况下,我们认为淋巴瘤的脊髓受累导致神经源性膀胱和腿部无力。IVL经常浸润中枢神经系统并出现神经系统症状，包括神经源性膀胱。因此,如果淋巴瘤伴有神经系统症状，应计划进行影像学检查以寻找中枢神经系统受累。此外,在LDH或可溶性白细胞介素2受体水平显著升高而无淋巴结肿大的患者中，IVL应该被怀疑，应考虑咨询血液学家。
