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Diagnostic Pathology
Published in: Diagnostic Pathology 1/2020

Open Access 01-12-2020 | Lymphoma | Case Report

EBV-positive intravascular large B-cell lymphoma of the liver: a case report and literature review

Authors: Qingjiao Li, Jinghe Li, Keda Yang, Ying Peng, Yao Xiang, Shuyuan Sun, Jian Zeng, Xin Zhang, Junpu Wang

Published in: Diagnostic Pathology | Issue 1/2020

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Abstract

Background

Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare subtype of diffuse large B-cell lymphoma that most commonly involves the central nervous system, skin, and bone marrow. To our knowledge, Epstein-Barr virus (EBV)-positive IVLBCL in the liver has never been reported in the literature.

Case presentation

We report a case of a 65-year-old Chinese man with complaint of fever for 18 days. No obvious abnormality was found by physical examination. Laboratory findings were notable for anemia, thrombocytopenia, and elevated level of serum lactate dehydrogenase. Bone marrow on smear, biopsy, and flow cytometry revealed no lymphoma. Imaging studies showed a slightly lower density lesion in the liver with high fluorodeoxyglucose uptake and hepatosplenomegaly. Percutaneous liver biopsy revealed clustering of large atypical lymphocytes within the hepatic sinusoids. Immunohistochemically, these lymphoma cells were positive for CD20, PAX-5, MUM-1, BCL-6 and CD5, but negative for CD3 and CD10. Besides, Epstein-Barr virus-encoded RNA was detected in tumor cells by in situ hybridization. BCL-2, BCL-6 and MYC genes were intact tested by fluorescence in situ hybridization analysis. The patient was diagnosed as IVLBCL and died after 1 month of hospitalization without receiving immunochemotherapy.

Conclusions

IVLBCL of the liver is a highly rare lymphoma with nonspecific manifestations and dismal prognosis. Full recognition of its clinicopathological features will help to better diagnose this disease.
Appendix
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Metadata
Title
EBV-positive intravascular large B-cell lymphoma of the liver: a case report and literature review
Authors
Qingjiao Li
Jinghe Li
Keda Yang
Ying Peng
Yao Xiang
Shuyuan Sun
Jian Zeng
Xin Zhang
Junpu Wang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2020
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/s13000-020-00989-x

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