Characteristics of Renal Intravascular Large B-cell Lymphoma

Intravascular large B-cell lymphoma of the central nervous system with renal involvement: a case report and literature review

Intravascular large B-cell lymphoma (IVLBCL) is a highly aggressive type of non-Hodgkin's lymphoma. The clinical manifestations and imaging of this disease are nonspecific, making diagnosis challenging. We report a case of a patient with recurrent stroke-like symptoms, primarily characterized by hemiplegia, vertigo, ataxia, and proteinuria. Brain MRI revealed multiple cerebral infarctions, microbleeds, and meningeal enhancement. Ultimately, the patient was diagnosed with IVLBCL through a brain tissue biopsy, and involvement of the kidneys was suspected. We suggest considering IVLBCL in patients who present with recurrent stroke-like symptoms, fluctuating neurological deficits, the aforementioned MRI findings, and involvement of other organs. Additionally, central nervous system vasculitis(CNSV) may represent a transitional manifestation of the disease. Pathological biopsy is the gold standard for diagnosis. We hope that through this case, doctors can gain a deeper understanding of IVLBCL, enabling early diagnosis and timely treatment to improve prognosis.

A Rare Case of Intravascular Large B-cell Lymphoma Presenting as Fever of Unknown Origin With Unexplained Proteinuria

Intravascular large B-cell lymphoma (IVLBCL) is a subtype of extranodal diffuse large B-cell lymphoma, characterized by neoplastic B-cell proliferation within blood vessels. Its nonspecific presentation, often as fever of unknown origin (FUO) and systemic symptoms, makes diagnosis challenging. We report the case of a 66-year-old male patient presenting with persistent fever, weight loss, and respiratory failure. Initial investigations, including bone marrow biopsy and imaging, were inconclusive. The lack of response to empirical therapy and the patient's worsening condition presented us with a diagnostic dilemma. The unexplained proteinuria led us to perform a renal biopsy, which confirmed IVLBCL through the identification of atypical B-cells in glomerular capillaries. This case highlights the importance of considering IVLBCL in persistent FUO cases and the role of specific tissue biopsy in diagnosis, even with nonspecific bone marrow studies. Early detection and prompt treatment are crucial, but prognosis remains poor due to diagnostic delays.

Effective management of a rare case of primary renal intravascular large B-cell lymphoma with modified R-CHOP regimen: A case report

Intravascular large B-cell lymphoma, known for its diverse organ involvement, presents significant diagnostic challenges, particularly when it affects the kidneys. This report highlights a rare case of primary renal intravascular large B-cell lymphoma in a 60-year-old male patient, who presented with persistent fever and renal dysfunction. The case underscores the intricacy of diagnosis and the efficacy of personalized treatment. Following the identification of primary renal intravascular large B-cell lymphoma, a modified R-CHOP regimen was administered, resulting in notable amelioration of symptoms and renal function following the initial treatment cycle. The patient achieved sustained complete remission without any complications after completing five subsequent R-CHOP cycles and two additional cycles of rituximab monotherapy, as confirmed by recent assessments. He is currently under regular follow-up for ongoing monitoring and improvement. This case adds to the limited yet expanding pool of knowledge concerning intravascular large B-cell lymphoma, emphasizing the necessity for personalized therapeutic strategies in atypical presentations. It also highlights the importance of early detection and customized intervention in managing rare lymphoma subtypes with unique organ involvement.