Intravascular large B-cell lymphoma in which pulmonary artery wedge aspiration cytology was useful for differential diagnosis

Abstract

A 67-year-old woman who had no underlying diseases developed dyspnea and fatigue 2 weeks prior to presentation at our hospital. She initially visited a local physician, who suspected congestive heart failure, and was then referred to our hospital. Thrombocytopenia, elevated serum lactate dehydrogenase, ground-glass opacities in bilateral lung fields, and hepatosplenomegaly indicated intravascular large B-cell lymphoma (IVLBCL) or pulmonary tumor embolism. Right-heart catheterization showed mild pulmonary hypertension, and pulmonary artery wedge aspiration cytology detected atypical B-cells. Random skin and bone marrow biopsies showed histological evidence compatible with IVLBCL. Chemotherapy was administered that improved her condition.