Abstract
Intravascular lymphoma (IVL) is a rare subtype of malignant lymphoma characterized by the proliferation of lymphoma cells in the lumina of small vessels of various organs. IVL is a rapidly progressive disease with a poor prognosis and is often difficult to diagnose because of its heterogeneous and non-specific symptoms. We herein report the rescued case of a 79-year-old male patient with IVL presenting with refractory circulatory shock. He initially complained of fever and appetite loss, and later developed circulatory shock and severe abdominal pain; he was diagnosed as having septic shock as a result of perforative peritonitis. He underwent an exploratory laparotomy, but no obvious abnormal findings were pointed out. He was transferred to the ICU postoperatively and presented with persistent circulatory shock and hyperlactacidemia refractory to fluid and catecholamine administration. His peripheral smear showed blast forms, so we performed bone marrow aspiration and random skin biopsies on ICU day 2 and 9, respectively, and the diagnosis of IVL with hemophagocytic syndrome was confirmed. Following a high-dose of methylprednisolone, antineoplastic agents were administered. He recovered from shock and was discharged to the general ward on ICU day 19.
