Multiple Spontaneous Remissions of Intravascular Large B-Cell Lymphoma before a Definitive Diagnosis: A Case Report

We report a case of intravascular large B-cell lymphoma (IVLBCL) characterized by three episodes of spontaneous remission before a definitive diagnosis. A 60-year-old man presented with headache and cognitive impairment, with elevated serum lactate dehydrogenase (LDH) and soluble interleukin-2 receptor levels. Although IVLBCL was suspected, a random skin biopsy and bone marrow examination yielded nonspecific findings, and the symptoms resolved spontaneously. Similar self-limited relapses occurred twice in this patient. Ten months after onset, persistent fever, neurological deterioration, hypoxemia, and sustained LDH elevation developed, and IVLBCL was finally diagnosed by a random skin biopsy. This case illustrates the extremely rare phenomenon of the repeated spontaneous remission in IVLBCL.