Small Cell Variant of Intravascular Large B-Cell Lymphoma: Highlighting a Potentially Fatal and Easily Missed Diagnosis

Figure 1

(a) Liver biopsy showing mild steatosis and dilated sinusoids, H&E stain, 4x magnification. (b) Extensive intravascular involvement of the liver by small atypical cells, H&E stain, 40x magnification. (c) Small intrasinusoidal lymphocytes highlighted by CD20, immunohistochemistry stain, 20x magnification. (d) The marrow showed involvement by atypical cells mostly of small size lymphocytes with an intrasinusoidal pattern, H&E stain, 40x magnification. (e) Small intrasinusoidal lymphocytes highlighted by CD20, immunohistochemistry stain, 20x magnification. (f, g) Subcutaneous vessel showing intravascular large atypical cells highlighted by CD20 confirming the diagnosis of IVLBCL, H&E, and immunohistochemistry stains, 40x magnification. (h, i) Small intrasinusoidal lymphocytes in the marrow in comparison with intravascular large atypical cells in the skin, H&E stains, 60x magnification.

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