{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T18:13:06Z","timestamp":1783620786538,"version":"3.55.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2026,6,22]]},"abstract":"<jats:p>Intravascular large B-cell lymphoma (IVLBCL) is a rare aggressive extra-nodal lymphoma characterised by malignant B-cells proliferating within small to medium blood vessels. Often termed the \u2018great mimicker\u2019, it can affect almost any organ with heterogeneous clinical features. Up to half of cases have central nervous system involvement, resembling inflammatory, autoimmune or vascular disease. We report a man in his 60s presenting with saddle paraesthesia, faecal incontinence and bilateral foot drop. MR scan of the spine showed longitudinally extensive transverse myelitis, multifocal supratentorial white matter lesions and optic neuritis. He was initially diagnosed with seronegative neuromyelitis optica spectrum disorder (NMOSD), which appeared to respond well to corticosteroids, plasma exchange and rituximab. However, 8 months, later he relapsed with progressive cytopenias, a rising serum lactate dehydrogenase and new cerebral infarcts despite intensified immunosuppression. Random skin biopsies diagnosed IVLBCL. This case shows that IVLBCL can mimic seronegative NMOSD and immunosuppression may mask the true diagnosis.<\/jats:p>","DOI":"10.1136\/pn-2026-005261","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:20:25Z","timestamp":1783617625000},"page":"pn-2026-005261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intravascular large B-cell lymphoma mimicking seronegative neuromyelitis optica spectrum disorder"],"prefix":"10.1136","author":[{"given":"Marc","family":"Waugh","sequence":"first","affiliation":[{"name":"Immunology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Ambati","sequence":"additional","affiliation":[{"name":"Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Quartermaine","sequence":"additional","affiliation":[{"name":"Haematology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Morgan","sequence":"additional","affiliation":[{"name":"Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Wood","sequence":"additional","affiliation":[{"name":"Dermatopathology Group, Anatomical Pathology, PathWest Laboratory Medical WA, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"McGettigan","sequence":"additional","affiliation":[{"name":"Immunology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerissa","family":"Jordan","sequence":"additional","affiliation":[{"name":"Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026070910201785000_pn-2026-005261v1.1","unstructured":"Wingerchuk DM , Palace J . IPND 2025: Revised Consensus Criteria, Classification, and Nomenclature for Neuromyelitis Optica Spectrum Disorders. Barcelona, Spain: ECTRIMS Congress, 2025."},{"key":"2026070910201785000_pn-2026-005261v1.2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-04-737445"},{"key":"2026070910201785000_pn-2026-005261v1.3","doi-asserted-by":"crossref","DOI":"10.3390\/cancers17142355","article-title":"Intravascular Lymphoma: A Unique Pattern Underlying a Protean Disease","volume":"17","author":"Della Mura","year":"2025","journal-title":"Cancers (Basel)"},{"key":"2026070910201785000_pn-2026-005261v1.4","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/ana.27132","article-title":"Unveiling the Clinical and Imaging Signatures of Intravascular Lymphoma of the Central Nervous System: A Multicentric Cohort Study","volume":"97","author":"Berthet","year":"2025","journal-title":"Ann Neurol"},{"key":"2026070910201785000_pn-2026-005261v1.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjno-2024-000915","article-title":"Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature","volume":"7","author":"Uawithya","year":"2025","journal-title":"BMJ Neurol Open"},{"key":"2026070910201785000_pn-2026-005261v1.6","doi-asserted-by":"crossref","first-page":"3236","DOI":"10.1111\/ene.15941","article-title":"Progressive conus medullaris lesions are suggestive of intravascular large B-cell lymphoma","volume":"30","author":"Kitahara","year":"2023","journal-title":"Eur J Neurol"},{"key":"2026070910201785000_pn-2026-005261v1.7","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00277-023-05525-7","article-title":"Distinct FDG PET\/CT avidity among newly diagnosed intravascular large B-cell lymphoma patients: a descriptive observational study","volume":"103","author":"Zhao","year":"2024","journal-title":"Ann Hematol"},{"key":"2026070910201785000_pn-2026-005261v1.8","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-11-887570"},{"key":"2026070910201785000_pn-2026-005261v1.9","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1177\/12034754221130257","article-title":"Recommendations for an Approach to Random Skin Biopsy in the Diagnosis of Intravascular B-Cell Lymphoma","volume":"27","author":"MacGillivary","year":"2023","journal-title":"J Cutan Med Surg"},{"key":"2026070910201785000_pn-2026-005261v1.10","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206573"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2026-005261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:20:26Z","timestamp":1783617626000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2026-005261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":10,"alternative-id":["10.1136\/pn-2026-005261"],"URL":"https:\/\/doi.org\/10.1136\/pn-2026-005261","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]}}}