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KMID : 0984720030350050355
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Infection and Chemotherapy
2003 Volume.35 No. 5 p.355 ~ p.359
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Intravascular Lymphomatosis Presenting as Fever of Unknown Origin with Peripheral Polyneuropathy
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Park Byeong-Bae
Kim Kap-Hyun
Son Jun-Seong
Ki Hyun-Kyun
Jung Sook-In
Oh Won-Sup
Peck Kyong-Ran
Jung Chul-Won
Song Jae-Hoon
Ko Young Hyeh
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Abstract
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Fever of unknown origin (FUO) is caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%). The literatures also reveal that 5-15% of FUO cases defy diagnosis, despite extensive studies. Diagnostic advances continuously modify the spectrum of FUO-causing diseases. Modern imaging techniques (e.g., ultrasound, CT scan, MRI) enable early detection of abscesses and solid tumors that used to be difficult to diagnose. But the correct diagnosis can be delayed because the tumor, such as rare hematologic malignancy, is difficult to be detected by various imaging studies. Intravascular lymphomatos.is (IVL) is a rare form of non-Hodgkin´s lymphoma and generally fatal disease characterized by extensive proliferation of neoplastic mononuclear cells within the lumina of blood vessels. The prognosis is usually extremely poor, with rapid death despite chemotherapy. The diagnosis is most frequently made after biopsy of skin or brain but is often established post mortem. Most patients with IVL present with FUO and nonspecific cutaneous and neurologic manifestations. Peripheral nerve system or pulmonary involvements are not common as initial menifestations. We report a case of intravascular lymphomatosis, presenting as FUO with peripheral polyneuropathy. We made early diagnosis of lVL by video-assisted thoracoscopic lung biopsy. She is improving with good performance after the 4`h cycle of chemotherapy till now.
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KEYWORD
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Lymphoma, Intravascular lymphomatosis, FUO
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