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April 15, 2013
Intravascular B–cell Lymphoma
Intravascular B-cell lymphoma is a rare but aggressive form of B-cell lymphoma that may be neurologically devastating. In this condition, there is luminal invasion of small and medium-sized blood vessels by lymphoma cells that may present as widespread and nonspecific neurologic symptoms and impairments. Intravascular lymphoma is often confused with CNS vasculitis because imaging may often demonstrate hyperintense DWI changes in a multi-vascular distribution, which is concerning for ischemia.  Diagnosis can be made by biopsy. Although prognosis is poor, a prompt diagnosis and initiation of therapy may slow disease progression. Rituximab-based chemotherapy regimens have recently been shown to double the progression-free survival period. 
Submitted by James Addington, M.D. Resident Physician, University of Virginia.
Disclosure: Dr. Addington reports no disclosures.
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