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Diagnostic Value of Deep Punch Biopsies in Intravascular Large B-cell Lymphoma
Omkar Mayur1, Zachary Ramsey1, Dorian Willhite1
1Drs. Mayur, Ramsey, Belcher, and Powell are from the Medical College of Georgia, Augusta University. Dr. Ramsey is from the Department of Pathology, and Drs. Belcher and Powell are from the Department of Dermatology. Dr. Powell also is from the Department of Pathology. Dr. Willhite is from the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia. Dr. White is from the Larimer County Coroner's Office, Fort Collins, Colorado.
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The purpose of this study was to determine the diagnostic efficacy of skin biopsies for detecting intravascular large B-cell lymphoma (IVBCL) at various body sites and to establish whether biopsies from hemangiomas yield higher diagnostic value. Postmortem 4-mm punch biopsies were collected from various anatomic sites of a patient with IVBCL, including random areas of the skin as well as targeted areas (hemangiomas). Each biopsy was evaluated to assess the degree and depth of IVBCL involvement. The primary study outcome measurement was the presence and extent of IVBCL involvement in skin biopsies. Involvement was graded on a scoring system that assessed IVBCL in vascular lumina and depth in the skin. Skin biopsy is a sensitive, cost-efficient method for IVBCL assessment, and optimizing biopsy strategies will improve diagnostic accuracy and subsequently patient outcomes.
