[Pathology of intravascular lymphoma]

The neuropathological findings of IVL are characterized by multiple infarctions involving the cerebral cortex and white matter, and infarctions, that do not affect the areas of major arterial supply. Histologically, the disorder is characterized by cerebral necrosis due to intravascular proliferation of tumor cells, with pronounced angiitis or thrombosis. IVL is also associated with frequent spinal cord involvement. At the time of recurrence increasing number of patients with IVL present with findings indistinguishable from those of primary malignant lymphoma of the brain, because advances in the treatment of IVL have increased the follow-up period of these patients. Intravascular proliferation of tumor cells in various organs is found in patients with IVL. The tumor cells also show extravascular proliferation and form tumor masses in the liver or adrenal gland. Neurological involvement of malignant lymphoma other than IVL includes primary malignant lymphoma of the brain, lymphomatous meningitis, neurolymphomatosis, and spinal cord compression from epidural metastases. We herein describe the differences between these disorders and IVL.