Recurrent fever, persistent cytopenia
10.3760/cma.j.cn121090-20241129-00492
- VernacularTitle:反复发热、全血细胞减少
- Author:
Yi MIAO
1
;
Jing ZHANG
;
Han ZHANG
;
Chongyang DING
;
Zhen WANG
;
Zhonglan SU
;
Jianyong LI
;
Wenyu SHI
Author Information
1. 南京医科大学第一附属医院血液科，淋巴瘤中心，南京 210029
- Publication Type:Journal Article
- From:
Chinese Journal of Hematology
2025;46(9):870-873
- CountryChina
- Language:Chinese
-
Abstract:
Intravascular large B-cell lymphoma (IVLBCL) is a rare large B-cell lymphoma subtype. We report a patient who presented with "recurrent fever and pancytopenia." A 64-year-old female patient had previously been diagnosed with Waldenstrom’s macroglobulinemia and had received zanubrutinib treatment. In February 2023, the patient revisited due to "recurrent fever and pancytopenia." A positron emission tomography/computed tomography scan demonstrated significant enlargement of the bilateral adrenal glands. After an adrenal biopsy, she was diagnosed with diffuse large B-cell lymphoma, not otherwise specified. The patient received chemotherapy with the R-CHOP regimen (rituximab + cyclophosphamide + doxorubicin + vincristine + prednisone). After three treatment courses, a cranial magnetic resonance imaging examination indicated central nervous system infiltration of the lymphoma. After reviewing the pathology of the adrenal biopsy, the final diagnosis was revised as IVLBCL. Despite aggressive treatment, the disease continued to progress, and the patient died two months later. According to a multidisciplinary level, this article discusses the case from the perspective of a multidisciplinary team collaboration, involving imaging, pathology, dermatology, and lymphoma, to provide reference opinions for the clinical diagnosis and treatment of IVLBCL.
