南予医学雑誌　第18巻

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南予医誌　Vol.18　No. １　2017－74－An intravascular large B-cell lymphoma with the unusual symptom of anasarca-type edema: A case reportAbstract　Intravascular large B-cell lymphoma（IVLBCL）is a rare type of malignant lymphoma characterized by selective proliferation of lymphocytes in the lumina of small vessels. Diagnosis is difficult because the symptoms vary. We here report an atypical case of IVLBCL presenting with anasarca-type edema. An 82-year-old male presented to our hospital with a １-month history of body weight gain, anasarca-type edema, and dyspnea. Computed tomography（CT）was unremarkable except for subcutaneous fat stranding over the whole body. Blood tests revealed thrombocytopenia and increased serum lactate dehydrogenase（LDH）and soluble interleukin-２ receptor（sIL-２R）levels. Pathological analysis of a random skin biopsy revealed proliferation of CD20- positive, large atypical lymphocytes in the small blood vessels, resulting in a diagnosis of IVLBCL. Ｒ-THP-COP（rituximab, tetrahydropyranyl adriamycin, cyclophosphamide, vincristine, prednisolone）chemotherapy was initiated and the symptoms improved dramatically after six courses. The patient achieved complete remission（CR）, which was maintained for ８ months.（Nan-yo Med J 2017; 18: 68-74.）keyword；intravascular large Ｂ-cell lymphoma, anasarca-type edemaFumiya OGURA1),Hisaharu SHIKATA2), Masahiko KANEKO2)Hideyuki NAKANISHI2)1)Postgraduate Clinical Training Center2)Department of Hematology　Uwajima City Hospital　Goten-machi, Uwajima, Ehime 798-8510, Japan