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Published on: March 30, 2018

Prevalence of intravascular large B-cell lymphoma with bone marrow involvement at initial presentation

Masafumi Ito1, Yonggoo Kim, Jong Weon Choi

  • 1Department of Pathology, Nagoya University Hospital, Nagoya, Japan. itom@med.nagoya-u.ac.jp

International Journal of Hematology
|March 12, 2003
PubMed

Insights

Intravascular lymphoma (IVL) was found in 8.2% of bone marrow samples from patients with fever of unknown origin or hemophagocytic syndrome. Immunohistochemical analysis of bone marrow aids in diagnosing IVL in these patients.

Area of Science:

  • Hematology
  • Oncology
  • Immunohistochemistry

Background:

  • Fever of unknown origin (FUO) and hemophagocytic syndrome (HPS) can present with complex hematological manifestations.
  • Intravascular lymphoma (IVL) is a rare non-Hodgkin lymphoma characterized by proliferation of malignant lymphocytes within small blood vessels.

Purpose of the Study:

  • To investigate the prevalence of intravascular lymphoma (IVL) in bone marrow (BM) specimens from patients diagnosed with fever of unknown origin (FUO) or hemophagocytic syndrome (HPS).
  • To evaluate the utility of immunohistochemical analysis of BM for diagnosing IVL in this patient cohort.

Main Methods:

  • Immunohistochemical analysis was performed on 146 bone marrow clot specimens.
  • Specimens were from patients with FUO (n=124) or HPS (n=22).
  • Diagnosis of IVL was based on identifying CD20+ and CD79a+ tumor cells within lumina, surrounded by CD34+ endothelial cells.

Main Results:

  • Intravascular lymphoma (IVL) was detected in 12 out of 146 patients (8.2%).
  • Of the 12 IVL cases, 6 were CD5 positive, and 5 of these were also vimentin positive.
  • CD20+, CD79a+, and CD34+ staining confirmed IVL confined within BM sinuses.

Conclusions:

  • The prevalence of IVL in BM samples from FUO and HPS patients suggests BM immunohistochemistry is valuable for IVL diagnosis.
  • Vimentin coexpression in CD5+ IVL may indicate an origin from a specific prefollicular B-cell subset.

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