Random skin biopsy and bone marrow biopsy for diagnosis of intravascular large B cell lymphoma
Random skin biopsy and bone marrow biopsy for diagnosis of intravascular large B cell lymphoma
复制标题
DOI：
10.1007/s00277-010-1101-3
复制
发表时间：
2011-04-01
影响因子：
3.5
通讯作者：
Takeuchi, Masami
中科院分区：
文献类型：
--
作者：
Matsue, Kosei;Asada, Noboru;Takeuchi, Masami
血管内淋巴瘤(IVL)是一种罕见的结外淋巴瘤，其淋巴瘤细胞仅在小血管的管腔内增殖。IVL的诊断需要组织学证实。虽然从疑似IVL患者的健康皮肤中随机抽取皮肤活检似乎是有用的，但这种方法对诊断IVL的敏感性仍不清楚。我们对过去4年来在我们机构连续诊断的12例IVL患者进行了随机的皮肤活检，并评估了其与临床和实验室特征、是否存在皮肤损害以及骨髓受累的相关性。所有12名患者都是死前通过随机皮肤活检或骨髓活检确诊的，并接受了含有利妥昔单抗的化疗。12例患者均进行了随机皮肤活检，阳性10例(83.3%)。12例患者中有3例皮肤红斑性病变，但2例活检发现淋巴瘤病变。12例患者中有11例(91.6%)经骨髓涂片和/或流式细胞仪分析发现有骨髓侵犯，但仅有一半患者经环钻活检发现有骨髓侵犯。我们的结论是，从外观正常的皮肤中随机进行皮肤活检在诊断IVL方面具有相当于骨髓环钻活检的高度敏感性。无论疑似IVL的患者是否有皮损，均应进行检查。
Intravascular lymphoma (IVL) is a rare type of extranodal lymphoma in which the lymphoma cells proliferate exclusively in the lumina of small vessels. The diagnosis of IVL requires histological confirmation. Although random skin biopsy from healthy-appearing skin in patients with suspected IVL appeared to be useful, the sensitivity of this method for the diagnosis of IVL remains unknown. We performed a random skin biopsy from 12 consecutive cases of IVL diagnosed at our institution over the past 4 years and evaluate its relevance of clinical and laboratory characteristics, presence or absence of skin lesions, and bone marrow involvement. All 12 patients were diagnosed antemortem by either random skin biopsy or bone marrow biopsy and treated with rituximab-containing chemotherapy. Random skin biopsy was performed in all 12 patients, and the results were positive in ten patients (83.3%). Erythematous skin lesions were seen in 3 of 12 patients, but biopsy was positive for lymphoma lesion in two patients. Bone marrow invasion was seen in 11 of the 12 patients (91.6%) by bone marrow smear and/or flow cytometric analysis, but was detected in only half of the patients by trephine biopsy. We concluded that random skin biopsy from normal-appearing skin is highly sensitive in the diagnosis of IVL comparable to bone marrow trephine biopsy. It should be performed irrespective of the presence or absence of skin lesions in patients who were suspicious of IVL.