Abstract
A 76-year-old female was admitted to our hospital with a history of easy fatigability and fever. Laboratory tests showed pancytopenia. In the initial course of hospitalization, the patient was diagnosed as having myelodysplastic syndrome and infections however, treatments proved ineffective with the patient gradually developing loss of consciousness and slipping into circulatory shock. The symptoms improved initially after steroid pulse therapy administered considering the possibility of a vasculitis syndrome, however, the symptoms worsened thereafter, with the appearance of the abdominal pain. Abdominal CT revealed free air and an increase of the ascites volume, and an emergency operation was performed under the tentative diagnosis of gastrointestinal perforation. The operative findings revealed intestinal gangrene and histopathological examination of the resected specimen revealed the diagnosis of intravascular lymphoma (IVL). The patient was admitted to the intensive care unit after surgery, and showed marked improvement of the clinical condition with chemotherapy for the IVL.
