Clinicopathological features of intravascular diffuse large B-cell lymphoma in the central nervous system:5 cases report
10.13315/j.cnki.cjcep.2025.09.008
- VernacularTitle:中枢神经系统血管内大B细胞淋巴瘤5例临床病理分析
- Author:
Jia LI
1
;
Yanru DU
;
Yuanbo LIU
;
Huanguang LIU
;
Qing LIU
;
Chunyan GUAN
;
Zifen GAO
;
Gehong DONG
Author Information
1. 首都医科大学附属北京天坛医院病理科,北京 100070
- Publication Type:Journal Article
- Keywords:
central nervous system tumors;
intravascular large B-cell lymphoma;
stereotactic brain biopsy;
chemotherapy
- From:
Chinese Journal of Clinical and Experimental Pathology
2025;41(9):1169-1174
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the clinical manifestations,imaging features,and histopathological characteristics of intravascular large B-cell lymphoma(IVL-BCL)involving the central nervous system(CNS).Methods Clinical and imaging data from 5 cases of IVL-BCL were collected.Immunohistochemical staining and FISH were performed to analyze their clinicopathological characteristics,with a comprehensive review of relevant literatures.Results All 5 pa-tients were elderly,with a male-to-female ratio of 4∶1,and an age of onset ranging from 53 to 67 years.The disease course varied from 4 months to 2 years.All patients had varying degrees of neurological damage symptoms.In this study,4 patients experienced varying degrees of weakness in the lower limbs.MRI findings were nonspecific,but all 5 patients showed evidence of cerebrovascular lesions.Histologically,the lesions were characterized by aggregates of lymphoid tumor cells within the lumens of small cerebral vessels,which could obstruct the lumens and cause ischemic and hypoxic changes.Tumor cells did not involve the extravascular brain parenchyma.Immunohistochemically,tumor cells widely expressed mature B-cell markers(CD19,CD20,CD79a,PAX5)with a high Ki67 proliferation index.All 5 patients received systemic chemotherapy after diagnosis,1 patient died,2 patients achieved clinical and physical symptom relief and were still under follow-up.2 patients were undergoing systemic examination before chemotherapy.Conclusion Intravascular large B-cell lymphoma involving the central nervous system is rare,and both clinical mani-festations and imaging examinations lack specific indicators.Preoperative diagnosis is very difficult and can only rely on diagnostic brain biopsy or pathological diagnosis after craniotomy.
