Intravascular lymphoma concomitant with gastric cancer associated with extremely high lactate dehydrogenase levels

Abstract

A 64-year-old Japanese man presented with a 2-month history of dyspnea and 1 month of visual disturbance. Laboratory results showed anemia, low platelets, hypoalbuminemia, and elevated lactate dehydrogenase (LDH). Due to high LDH with isozyme II predominance, we suspected intravascular lymphoma (IVL) and performed random skin and bone marrow biopsies, which showed intravascular large B-cell lymphoma with hemophagocytosis. Although nonspecific symptoms are common in IVL, increased serum LDH and hypoalbuminemia are important clinical features. Performing random skin and bone marrow biopsies for Asian patients with IVL is imperative due to the high incidence of bone marrow lesions.