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[Intravascular lymphoma causing acute abdomen].

S M Kröber1

  • 1Pathologisches Institut Koblenz. skroeber@pathologie-koblenz.de

Der Pathologe
|December 6, 2006
PubMed
Summary
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Intravascular B-cell lymphoma (IVL) can cause acute abdominal pain by blocking blood vessels. This rare cancer should be considered in unexplained ischemic conditions with fever.

Area of Science:

  • Oncology
  • Vascular Medicine
  • Pathology

Background:

  • Diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy, typically presenting with cephalic or cutaneous manifestations.
  • Intravascular B-cell lymphoma (IVL) is a rare subtype of DLBCL characterized by the proliferation of malignant lymphocytes within blood vessels.
  • While visceral IVL is common at autopsy, its presentation as an acute abdomen is infrequently reported.

Observation:

  • A 65-year-old male presented with acute abdominal pain and fever, initially suspected as small bowel gangrene.
  • Pathological examination revealed extensive obliteration of abdominal vessels by lymphoma cells.
  • The findings indicated intravascular B-cell lymphoma as the cause of the ischemic event.

Findings:

  • The patient's acute abdomen was caused by diffuse large B-cell lymphoma infiltrating and obstructing abdominal vasculature.

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  • The obstruction of small and large abdominal vessels by lymphoma cells, potentially combined with fibrin thrombi, led to organ infarction.
  • This case highlights a rare but critical presentation of IVL.

    • Implications:

    • Intravascular B-cell lymphoma should be included in the differential diagnosis for patients presenting with acute abdomen and fever of unknown origin.
    • Early consideration of IVL in ischemic conditions can lead to timely diagnosis and treatment.
    • This case underscores the importance of considering rare oncological causes for seemingly common surgical emergencies.