[Case of intravascular lymphoma diagnosed by transbronchial lung biopsy, with transient spontaneous remission]

A 70-year-old man visited hospital because of intermittent fever (about 38 degrees C) and night sweat. He had a history of smoking of 1 pack a day for 35 years. He had no abnormal findings on physical examination, but had abnormal laboratory findings, including elevated C-reactive protein, lactate dehydrogenase and soluble interleukin-2 receptor levels. Although malignant lymphoma was suspected, his symptoms and laboratory findings resolved spontaneously. However, intermittent fever and night sweat reoccurred 19 months after his first presentation, and he visited our hospital with dyspnea the following month. On physical examination, he had no abnormal findings. A chest radiograph showed no abnormal findings, but chest and abdominal CT images revealed diffuse ground-glass opacities in both lung fields, and splenomegaly. Transbronchial lung biopsy (TBLB) confirmed a diagnosis of intravascular large B-cell lymphoma. Spontaneous remission is rare in aggressive lymphomas, including intravascular lymphomas (IVL). We report a case of IVL, with symptoms which resolved spontaneously, and reoccurred 19 months later with diffuse interstitial shadows on chest CT images, and in which a diagnosis of IVL was confirmed by TBLB.