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. 2025 Oct;40(8):768-776.
doi: 10.1016/j.nrleng.2025.09.008.

A single institution series of intravascular lymphoma: Neurological manifestations and neuroimaging findings

J Corroza  1 , C Alburquerque  2 , L Martínez-Martínez  1 , I Gastón  3 , L Torné  3 , M C Gil-Alzueta  1 , J Oteiza  4 , T Cabada  5 , M C Viguria  2 , A Panizo  6 , M E Erro  7
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Free article

A single institution series of intravascular lymphoma: Neurological manifestations and neuroimaging findings

J Corroza et al. Neurologia (Engl Ed). 2025 Oct.
Free article

Abstract

Background: Intravascular lymphoma (IVL) is a diffuse large B-cell lymphoma characterized by occlusion of small vessels of organs by malignant cells with special tropism for the nervous system. Our purpose has been to describe a series of IVL diagnosed in our center and to compare the results with those of the literature.

Methods: A retrospective review of the clinical, imaging, and pathological data of consecutive patients with IVL in the last 20 years was performed. Pathology department database was the source of patient identification.

Results: We identified six cases (three males and three females), with a median age at diagnosis of 54.64 (interquartile range (IR) 51.93-59.67). Five of them (83.3%) debuted with neurological manifestations. The median time to diagnosis was 3.77 months. On cranial magnetic resonance imaging, the findings consisted of multiple white matter and corpus callosum lesions (some of them with enhancement or hemorrhagic foci) and multifocal infarcts with hemorrhagic transformation. One patient displayed leptomeningeal branch aneurysms. A proton emission tomography with fluorodeoxyglucose (PET-FDG) was performed in five patients showing areas of elevated metabolism in all of them. Four patients underwent targeted biopsy, which allowed the diagnosis of IVL to be established in three. Four of the five patients who received treatment remained in complete remission with a median progression-free survival of 69.62 months (IR 49.11-162.82).

Conclusions: IVL begins frequently with neurological manifestations, which must alert the neurologist to be aware of this entity. PET-FDG helps to identify biopsy-accessible lesions and facilitate early diagnosis of IVL.

Keywords: B-cell lymphoma; Linfoma de células B; Nervous system; Neuroimagen; Neuroimaging; Neuropathology; Neuropatología; Proton emission tomography; Sistema nervioso; Supervivencia; Survival; Tomografía de emisión de positrones.

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