{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:16:26Z","timestamp":1787008586899,"version":"build-2736575974"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intravascular large B-cell lymphoma (IVLBCL) is a rare extranodal lymphoma characterized by selective growth of neoplastic lymphocytes within small vessels, often lacking lymphadenopathy or circulating malignant cells. Its clinical heterogeneity and nonspecific symptoms frequently cause delayed diagnosis and treatment. We report three older patients presenting with unexplained anaemia, with systemic symptoms in two patients and purpuric skin lesions in one. All were diagnosed via skin biopsy (a purpuric lesion, haemangioma-like lesion and random normal skin, respectively), which revealed intravascular atypical B cells. Two patients developed haemophagocytic syndrome (HPS), aligning with the Asian variant of IVLBCL. One patient had haemangioma-like nodules and lymphadenopathy. These patients highlight the clinical heterogeneity of IVLBCL and emphasize the diagnostic value of skin biopsy in patients with features of HPS (unexplained fever, cytopenia and elevated lactate dehydrogenase or ferritin).<\/jats:p>","DOI":"10.1093\/ced\/llaf413","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T11:47:43Z","timestamp":1757159263000},"page":"98-102","source":"Crossref","is-referenced-by-count":1,"title":["When diagnostic clues are hidden in small blood vessels of the skin: diagnostic challenge in intravascular large B-cell lymphoma"],"prefix":"10.1093","volume":"51","author":[{"given":"I Lun","family":"Tseng","sequence":"first","affiliation":[{"name":"Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan ,","place":["Taiwan"]},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Yu-Yun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2742-3268","authenticated-orcid":false,"given":"Chih-Cheng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Tainan Municipal An-Nan Hospital , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaw-Ning","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan ,","place":["Taiwan"]},{"name":"School of Pharmacy, College of Medicine, Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-An","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Chi-Mei Medical Center , Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chen","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan 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literatures","volume":"44","author":"Ong","year":"2021","journal-title":"Biomed J"},{"key":"2025122312171432800_llaf413-B7","doi-asserted-by":"crossref","first-page":"103078","DOI":"10.1016\/j.eclinm.2025.103078","article-title":"Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone combined with high-dose methotrexate plus intrathecal chemotherapy for newly diagnosed intravascular large B-cell lymphoma (PRIMEUR-IVL): long-term results of a multicentre, single-arm, phase 2 trial","volume":"80","author":"Shimada","year":"2025","journal-title":"EClinicalMedicine"},{"key":"2025122312171432800_llaf413-B8","doi-asserted-by":"crossref","first-page":"10531","DOI":"10.2147\/CMAR.S267825","article-title":"Prognosis of intravascular large B cell lymphoma (IVLBCL): analysis of 182 patients from global case series","volume":"12","author":"Liu","year":"2020","journal-title":"Cancer Manag Res"},{"key":"2025122312171432800_llaf413-B9","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s12185-024-03757-5","article-title":"Optimizing random skin biopsies: a review of techniques and indications for intravascular large B-cell lymphoma","volume":"119","author":"Enzan","year":"2024","journal-title":"Int J Hematol"},{"key":"2025122312171432800_llaf413-B10","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.annder.2019.01.017","article-title":"The value of healthy skin biopsy in the diagnosis of intravascular B-cell lymphoma: a case report and systematic literature review","volume":"146","author":"Diaz","year":"2019","journal-title":"Ann Dermatol Venereol"}],"container-title":["Clinical and Experimental 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