Tuesday, April 22, 2008

Intravascular B-cell lymphoma with febrile inflammatory lymphedema of the lower limbs and lower back

Intravascular B-cell lymphoma with febrile inflammatory lymphedema of the lower limbs and lower back

Ann Dermatol Venereol. 2008 AprPallure V, Dandurand M, Stoebner PE, Habib F, Colonna G, Meunier L.Service de dermatologie, groupe hospitalo-universitaire Carémeau, ruedu Professeur-Robert-Debré, 30900 Nîmes, France.

BACKGROUND: Intravascular lymphomas are diffuse large-cell lymphomas belonging to a group of high-grade non-Hodgkin's lymphomas and are generally of phenotype B. They are rare and carry a severe prognosis.Clinical polymorphism is dominated by neurological and cutaneous involvement.

PATIENTS AND METHODS: We report the case of an 80-year-old woman with cutaneous intravascular B-cell lymphoma as revealed by an isolated episode of febrile bilateral inflammatory lymphedema. Following combined chemotherapy with rituximab and mini-CHOP (cyclophosphamide,adriamycin, oncovin and prednisone), complete remission was obtained rapidly, with no relapse at two years.

DISCUSSION: Diagnosis of these tumours is rendered difficult by theclinical polymorphism and multifocal nature of lymphocytic proliferations. In the present case, diagnosis was based on histology results since presentation of the disease in the form of bilateral inflammatory edema of the lower limbs is not sufficient to establish lymphoma. Combined rituximab and polychemotherapy comprising a CHOP regimen appears to yield the best results.

Elsevier/Science Direct