부산대학교 도서관

Intravascular large B-cell lymphoma (IVLBCL) is a disease in which lymphoma proliferates within vessels and is characterized by anemia, hypoalbuminemia, and high levels of serum lactate dehydrogenase. We experienced a case of IVLBCL that was difficult to diagnose because cerebral infarctions preceded these symptoms. A 65-year-old man was admitted to our hospital due to dizziness. Head magnetic resonance imaging showed new infarctions in multiple areas. Transesophageal echocardiography revealed a thrombus in the auricle of the left atrium, and we started anticoagulation therapy. However, he had relapses of cerebral infarctions. During the course of the disease, a slight fever appeared, and anemia, hypoalbuminemia, and high levels of serum lactate dehydrogenase and soluble interleukin-2 receptors were observed. We performed a random skin biopsy and diagnosed IVLBCL. He was treated with chemotherapy, but he died three years later. In this case, a thrombus in the auricle of his left atrium made distinguishing IVLBCL from cardiogenic cerebral embolism difficult until he showed systemic symptoms. IVLBCL should be considered when relapses of cerebral infarction occur within a short period of time while on anticoagulation therapy.