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Related Experiment Videos

Intravascular lymphomatosis presenting within angiolipomas.

M E Smith1, M D Stamatakos, T S Neuhauser

  • 1Department of Pathology, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5300, USA.

Annals of Diagnostic Pathology
|April 11, 2001
PubMed
Summary
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This case report details intravascular lymphomatosis found within an angiolipoma. This aggressive cancer, often diagnosed postmortem, presents varied symptoms and requires consideration in vascular invasion diagnoses.

Area of Science:

  • Oncology
  • Pathology
  • Hematology

Background:

  • Intravascular lymphomatosis (IVL) is a rare, aggressive hematologic malignancy characterized by the proliferation of lymphoid cells within blood vessels.
  • It can affect any organ system, with common presentations involving the central nervous system and skin.
  • Diagnosis is often challenging and frequently made postmortem due to its insidious onset and diverse clinical manifestations.

Observation:

  • A case of IVL was identified within an angiolipoma in a 73-year-old woman with a history of breast cancer.
  • Microscopic examination revealed vascular spaces filled with atypical, pleomorphic cells expressing CD45RB and CD20.
  • The patient later developed widespread lesions and neurological symptoms, ultimately succumbing to the disease.

Findings:

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  • Immunohistochemical analysis confirmed the atypical cells as B-cell lymphocytes, consistent with IVL.
  • The angiolipoma served as an unusual site for the initial presentation of IVL.
  • The patient's progression to widespread disease and CNS involvement highlights the aggressive nature of IVL.

Implications:

  • This case underscores the importance of considering IVL in the differential diagnosis of vascular lesions, especially when atypical cells are present.
  • Recognizing the protean manifestations of IVL is crucial for earlier diagnosis and potential intervention.
  • The findings emphasize the need for vigilance in evaluating vascular anomalies, particularly in patients with a history of malignancy.