A Case of Intravascular Large B-cell Lymphoma That Was Overlooked due to Nonspecific Symptoms During Combination Immunotherapy for Left Upper Lobe Lung Adenocarcinoma

DOI Web Site 12 References
  • Nonaka Yuto
    Department of General Thoracic Surgery, Kirishima Medical Center
  • Yanagi Masakazu
    Department of General Thoracic Surgery, Kirishima Medical Center
  • Sakagami Yuri
    Department of General Thoracic Surgery, Kirishima Medical Center
  • Ohnou Nobuhito
    Department of Hematology, Kirishima Medical Center
  • Tanimoto Akihide
    Department of Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Ueda Kazuhiro
    Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University

Bibliographic Information

Other Title
  • 左上葉肺腺癌に対する複合免疫療法中に非特異的所見のため鑑別困難であった血管内大細胞型B細胞リンパ腫の1例
Published
2024-10-20
DOI
  • 10.2482/haigan.64.872
Publisher
The Japan Lung Cancer Society

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Description

<p>Background. Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma characterized by selective lymphoma cell growth in the lumina of vessels, mainly capillaries. We report a case of IVLBCL that was overlooked due to nonspecific symptoms during combination immune checkpoint inhibitor (ICI) therapy for lung cancer. Case. The patient was a 68-year-old man who was on maintenance therapy (pembrolizumab+PEM) for left upper lobe lung adenocarcinoma (cT2a (PL1) N0M1c (bone marrow, spleen) stage IVB). The patient was admitted to hospital with complaints of general fatigue and dyspnea and was treated for immune-related adverse events (irAE) because of pancytopenia and hypothyroidism. However, the symptoms did not improve. Multiple bone marrow punctures were performed to investigate the possibility of malignant lymphoma or recurrent bone marrow metastasis; however, no malignant cells were found. The patient was diagnosed with IVLBCL based on a random skin biopsy. Conclusion. IVLBCL is a malignant lymphoma that occurs without lymph node enlargement, and which has limited specific findings. Aggressive additional tests are important to distinguish IVLBCL from irAE during the administration of ICI therapy.</p>

Journal

  • Haigan

    Haigan 64 (6), 872-877, 2024-10-20

    The Japan Lung Cancer Society

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