Clinical and Histopathological Findings of Six Cases of Intravascular Large B-cell Lymphoma Diagnosed from 161 Random Skin Biopsy Cases.

Six of 161 patients who underwent random skin biopsy were diagnosed with intravascular large B-cell lymphoma (IVLBCL).

• A total of 161 patients with malignant lymphoma in the differential diagnosis underwent random skin biopsies.
• Six patients were diagnosed with IVLBCL, 12 patients were diagnosed with other malignant lymphomas, and the remainder were diagnosed with other diseases.
• Clinical presentations prompting biopsy included fever, night sweats, and unintentional weight loss.

Patients diagnosed with IVLBCL had a statistically significant tendency to present with B symptoms compared to non-IVLBCL patients.

• The association between IVLBCL diagnosis and B symptoms was statistically significant (p = 0.046).
• B symptoms include fever, night sweats, and unintentional weight loss.

The presence of senile/cherry angioma(s) at the sites of random skin biopsies was significantly associated with a diagnosis of IVLBCL.

• Inclusion of senile/cherry angioma(s) at biopsy sites was associated with IVLBCL diagnosis (p = 0.040).
• This finding suggests that targeting senile/cherry angiomas during random skin biopsy may improve diagnostic yield for IVLBCL.

Thrombocytopenia was significantly associated with a diagnosis of IVLBCL.

• Thrombocytopenia was significantly more common in IVLBCL patients compared to others (p = 0.009).
• This was the most statistically significant of the three identified clinical/laboratory associations.

Random skin biopsy is recommended for patients presenting with B symptoms and thrombocytopenia, with a caveat regarding hemophagocytic lymphohistiocytosis.

• Patients with IVLBCL who have B symptoms and thrombocytopenia tend to be easily diagnosed via random skin biopsy.
• The authors recommend random skin biopsy in cases with these manifestations.
• An exception is noted: random skin biopsy is not recommended if patients have hemophagocytic lymphohistiocytosis.
• IVLBCL is described as a rare type of extranodal lymphoma with an aggressive and sometimes fatal course, making early diagnosis necessary to improve prognosis.