[Two cases of intravascular lymphomatosis diagnosed by transbronchial lung biopsy]

Patient 1 was a 54-year-old woman who was admitted with high-grade fever. Abnormal laboratory findings included hypoxemia, and elevated levels of LDH and soluble interleukin-2 receptor (sIL-2R). Chest computed tomography scans (CT) revealed diffuse ground-glass shadows in both lungs. Transbronchial lung biopsy (TBLB) confirmed the diagnosis of intravascular lymphomatosis (IVL). Patient 2 was a 46-year-old man who was also admitted with high-grade fever. Abnormal laboratory findings included slight hypoxemia, and elevated levels of LDH and sIL-2R. Chest CT images revealed diffuse, fine nodular densities in both lungs and several small nodules in the bilateral lower lobes. Perfusion scintigraphy revealed multiple defects in both lungs. TBLB specimens yielded a diagnosis of IVL. Although antemortem diagnosis of IVL is frequently difficult, it is necessary to perform TBLB in those patients who show fever not responding to antibiotics, elevated levels of LDH and sIL-2R, and hypoxemia.