{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T16:48:06Z","timestamp":1746204486563},"reference-count":15,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIntravascular large B-cell lymphoma (IVLBCL) is a rare entity among large B-cell non-Hodgkin lymphomas and is often difficult to diagnose. We report the case of a patient with IVLBCL who presented with central nervous system (CNS) symptoms alone, in which positron emission tomography (PET) enabled a rapid and accurate diagnosis.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nAn 81-year-old woman was admitted to our hospital with a 3-month history of gradually progressive dementia and declining spontaneity. Magnetic resonance imaging revealed multiple hyperintense lesions bilaterally on diffusion-weighted imaging without enhancement on gadolinium-enhanced T1-weighted imaging. Laboratory findings showed elevated serum lactate dehydrogenase (626 U\/L) and soluble interleukin-2 receptor (sIL-2R) (4692 U\/mL). Cerebrospinal fluid (CSF) analysis showed slightly elevated levels of protein (166 mg\/dL) and lymphocytic cells (29\/\u03bcL), and \u03b22-microglobulin (\u03b22-MG) (4.6 mg\/L) was highly elevated. Whole-body computed tomography revealed faint ground-glass opacities in the upper and middle lung fields and diffuse enlargement of both kidneys without lymph node swelling. 18<\/jats:sup>F-fluorodeoxyglucose (FDG)-PET showed diffuse and remarkably high FDG uptake in both upper lungs and kidneys without uptake by lymph nodes, suggesting a malignant hematological disease. IVLBCL was confirmed histologically by incisional random skin biopsy from the abdomen. Chemotherapy using R-CHOP regimen in combination with intrathecal methotrexate injection was started on day 5 after admission and follow-up neuroimaging showed no signs of recurrence.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nIVLBCL presenting with CNS symptoms alone is rare and often has a poor prognosis associated with delayed diagnosis, and various evaluations (including systemic analysis) are therefore necessary for early diagnosis. FDG-PET, in addition to identification of clinical symptoms and evaluation of serum sIL-2R and CSF \u03b22-MG, enables rapid therapeutic intervention in IVLBCL presenting with CNS symptoms.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1175_2022","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T08:24:00Z","timestamp":1679041440000},"page":"89","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical utility of positron emission tomography leading to rapid and accurate diagnosis of intravascular large B-cell lymphoma presenting with the central nervous system symptoms alone: A case report and review of the literature"],"prefix":"10.25259","volume":"14","author":[{"given":"Ryo","family":"Inagaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kota","family":"Kanehisa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joji","family":"Kunihiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Kondo","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Katayama","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mashio","family":"Taniwaki","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Shigekawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riko","family":"Kitazawa","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeharu","family":"Kunieda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"10.25259\/SNI_1175_2022\/ref-1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1111\/j.1600-0404.1995.tb00452.x","article-title":"Neurologic manifestations of intravascular lymphomatosis","volume":"91","author":"Chapin","year":"1995","journal-title":"Acta Neurol Scand"},{"key":"10.25259\/SNI_1175_2022\/ref-2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/bjd.17603","article-title":"Incisional random skin biopsy, not punch biopsy, is an appropriate method for diagnosis of intravascular large B-cell lymphoma: A clinicopathological study of 25 patients","volume":"181","author":"Enzan","year":"2019","journal-title":"Br J Dermatol"},{"key":"10.25259\/SNI_1175_2022\/ref-3","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1002\/1097-0142(19930515)71:10<3156::AID-CNCR2820711043>3.0.CO;2-O","article-title":"Intravascular lymphomatosis. A systemic disease with neurologic manifestations","volume":"71","author":"Glass","year":"1993","journal-title":"Cancer"},{"key":"10.25259\/SNI_1175_2022\/ref-4","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1182\/blood-2003-05-1545","article-title":"Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray","volume":"103","author":"Hans","year":"2004","journal-title":"Blood"},{"key":"10.25259\/SNI_1175_2022\/ref-5","doi-asserted-by":"crossref","first-page":"4114","DOI":"10.1002\/cam4.3048","article-title":"Multi-marker algorithms based on CXCL13, IL-10, sIL-2 receptor, and \u03b22-microglobulin in cerebrospinal fluid to diagnose CNS lymphoma","volume":"9","author":"Maeyama","year":"2020","journal-title":"Cancer Med"},{"key":"10.25259\/SNI_1175_2022\/ref-6","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1200\/JCO.2006.08.2313","article-title":"Definition, diagnosis, and management of intravascular large B-cell lymphoma: Proposals and perspectives from an international consensus meeting","volume":"25","author":"Ponzoni","year":"2007","journal-title":"J Clin Oncol"},{"key":"10.25259\/SNI_1175_2022\/ref-7","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1182\/blood-2017-04-737445","article-title":"Intravascular large B-cell lymphoma: A chameleon with multiple faces and many masks","volume":"132","author":"Ponzoni","year":"2018","journal-title":"Blood"},{"key":"10.25259\/SNI_1175_2022\/ref-8","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/neup.12767","article-title":"Intravascular large B-cell lymphoma affecting multiple cranial nerves: A histopathological study","volume":"41","author":"Porzionato","year":"2021","journal-title":"Neuropathology"},{"key":"10.25259\/SNI_1175_2022\/ref-9","first-page":"65","article-title":"Early detection of intravascular large B-cell lymphoma by (18) FDG-PET\/CT with diffuse FDG uptake in the lung without respiratory symptoms or chest CT abnormalities","volume":"2","author":"Shiiba","year":"2014","journal-title":"Asia Ocean J Nucl Med Biol"},{"key":"10.25259\/SNI_1175_2022\/ref-10","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/S1470-2045(09)70140-8","article-title":"Presentation and management of intravascular large B-cell lymphoma","volume":"10","author":"Shimada","year":"2009","journal-title":"Lancet Oncol"},{"key":"10.25259\/SNI_1175_2022\/ref-11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1212\/CPJ.0000000000000185","article-title":"Neurologic manifestations of intravascular large B-cell lymphoma","volume":"6","author":"Tahsili-Fahadan","year":"2016","journal-title":"Neurol Clin Pract"},{"key":"10.25259\/SNI_1175_2022\/ref-12","first-page":"32S","article-title":"Use of fluorodeoxyglucose-positron emission tomography in the diagnosis of intravascular diffuse large B-cell lymphoma","volume":"33","author":"Tobin-Vealey","year":"2016","journal-title":"Fed Pract"},{"key":"10.25259\/SNI_1175_2022\/ref-13","first-page":"101625","article-title":"A case of lung intravascular large B cell lymphoma developed with respiratory failure rescued by corticosteroid prior to definite diagnosis","volume":"37","author":"Tsuji","year":"2022","journal-title":"Respir Med Case Rep"},{"key":"10.25259\/SNI_1175_2022\/ref-14","doi-asserted-by":"crossref","first-page":"e27996","DOI":"10.1097\/MD.0000000000027996","article-title":"Intravascular large B-cell lymphoma presenting as rapidly progressive dementia and stroke: A case report","volume":"100","author":"Wu","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"10.25259\/SNI_1175_2022\/ref-15","doi-asserted-by":"crossref","first-page":"4571","DOI":"10.21037\/tcr-21-769","article-title":"Intravascular large B-cell lymphoma with diffuse ground glass lesion on chest computed tomography diagnosed using transbronchial lung cryobiopsy: A case report","volume":"10","author":"Zhu","year":"2021","journal-title":"Transl Cancer Res"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/clinical-utility-of-positron-emission-tomography-leading-to-rapid-and-accurate-diagnosis-of-intravascular-large-b-cell-lymphoma-presenting-with-the-central-nervous-system-symptoms-alone-a-case-report\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/clinical-utility-of-positron-emission-tomography-leading-to-rapid-and-accurate-diagnosis-of-intravascular-large-b-cell-lymphoma-presenting-with-the-central-nervous-system-symptoms-alone-a-case-report\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T08:24:14Z","timestamp":1679041454000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/clinical-utility-of-positron-emission-tomography-leading-to-rapid-and-accurate-diagnosis-of-intravascular-large-b-cell-lymphoma-presenting-with-the-central-nervous-system-symptoms-alone-a-case-report\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,17]]},"references-count":15,"alternative-id":["10.25259\/SNI_1175_2022"],"URL":"https:\/\/doi.org\/10.25259\/sni_1175_2022","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,17]]},"article-number":"89"}}