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Review
. 2013 Oct 30:2013:bcr2013201643.
doi: 10.1136/bcr-2013-201643.

Massive splenomegaly and lymphopenia: a unique case of obstructive shock

Nikhil Anand Huprikar  1 , Maria T Kurtz, Cristin A Mount
Affiliations
Review

Massive splenomegaly and lymphopenia: a unique case of obstructive shock

Nikhil Anand Huprikar et al. BMJ Case Rep. .

Abstract

We present a patient with intravascular large B-cell lymphoma (IVLBCL)-induced obstructive shock. This case represents a unique presentation of the disease, while highlighting the difficulty of establishing the diagnosis. Although there was a high clinical suspicion for a lymphomatous process, the obstructive shock component of the patient's presentation was perplexing. It was not until the autopsy reports demonstrated lymphocytes within the pulmonary vasculature that the clinical picture of altered mental status, weight loss and obstructive shock were unified to the diagnosis of intravascular large B-cell lymphoma.

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Figures

Figure 1
Figure 1
Large heterogeneous, mass-like appearance of the spleen.
Figure 2
Figure 2
(A) Neoplastic cells filling a vessel in a postmortem lung artery section on H&E stain. (B) The atypical intravascular lymphocytes within a lung artery showing strong staining for a B-cell associated antigen, CD20.
See this image and copyright information in PMC

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