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Correspondence |

A Case of Intravascular Large B-Cell Lymphoma With Atypical Clinical Manifestations and Analysis of CXCL12 and CXCR4 Expression

Saeko Nakajima, MD; Kouichi Ohshima, MD, PhD; Masahisa Kyogoku, MD, PhD; Yoshiki Miyachi, MD, PhD; Kenji Kabashima, MD, PhD
Arch Dermatol. 2010;146(6):686-687. doi:10.1001/archdermatol.2010.113.
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Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive disease. Clinical cutaneous manifestations include purpuric to red macules, plaques, or nodules. Aggregation of atypical large B cells confined within the vascular lumen is the salient histologic characteristic, but the mechanism underlying this vessel-associated infiltration remains unexplained.1,2

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Clinical and histologic findings. A, Asymptomatic purpuric patches with marked edema on the right exterior lower leg. B, Reddish waxy papule on the abdomen. C, Skin biopsy specimen from the right lower leg shows infiltrates of large fibroblasts within vessels in the mid and deep dermis (hematoxylin-eosin, original magnification ×40). D, Intravascular cells with large prominent nuclei and irregular nuclear contours (hematoxylin-eosin, original magnification, ×400). E, CD20 positive staining in neoplastic cells (diaminobenzidine stain, original magnification, ×400). F and G, CXC chemokine receptor 4 (F) and CXC chemokine ligand 12 (G) stainings (original magnification ×400); negative isotype-matched control samples of antibody staining are shown in the insets. H and I, CXC chemokine receptor 3 (H) and CXC ligand 9 (I) stainings (original magnification ×400).

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