Back issues No.4 - 2009 / Case Report  

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Generalized Edema and Telangiectasia: Unusual Presentation of Intravascular Large B-cell Lymphoma
Chia-Mao Kao, Ying-Jui Chang, Cheng-Hsiang Hsiao, Yu-Ling Hsu, Ping-Huai Wang, Tsung-Hua Tsai, Lin-Hui Su
Dermatol Sinica 27: 248-253, 2009

Intravascular large B-cell lymphoma is characterized by clusters of large neoplastic B cells
within small blood vessels, most commonly in the dermis and subcutis. There is no nodal or
parenchymal involvement until late in the disease, and its endothelial tropism is responsible for
the variable clinical features. We report the case of a 51 year-old man who presented with fever,
altered mental status, generalized edema, and profound telangiectasia. The diagnosis was made
by a skin biopsy from the right thigh. Histology revealed ectatic vessels in the superfi cial dermis
and large atypical lymphoid cells fi lling the small blood vessels in the deep dermis. Immunohistochemical
staining showed strongly positive results for CD45 and CD79a. This was a rare case
of intravascular large B-cell lymphoma with generalized edema and telangiectasia as the only
cutaneous manifestation.

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