A case of intravascular large B-cell lymphoma (IVLBCL) with no abnormal findings on chest computed tomography diagnosed by random transbronchial lung biopsy

Intern Med. 2010;49(24):2697-701. doi: 10.2169/internalmedicine.49.3986. Epub 2010 Dec 15.


A 58-year-old woman was admitted with refractory fever despite receiving broad-spectrum antibiotics. She had hypoxemia, severe anemia, elevated levels of serum lactic dehydrogenase and soluble interleukin-2 receptor, and a positive direct Coombs test, which suggested an underlying autoimmune hemolytic anemia (AIHA). Chest computed tomography (CT) showed no abnormal findings, but she had hypoxia, and her alveolar-arterial oxygen difference (A-aDO2) was increased. A random transbronchial lung biopsy (TBLB) was performed, and pathological analysis showed massive proliferation of tumor cells in the lumina of the small vessels. Intravascular large B-cell lymphoma (IVLBCL) was diagnosed, and her general status improved after chemotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • Bronchoscopy* / methods
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Middle Aged
  • Tomography, X-Ray Computed* / methods