Intravascular large B-cell lymphoma resembling invasive fungal rhinosinusitis: An autopsy case report

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma (ML). Here, we present a case of IVLBCL initially suspected as invasive fungal rhinosinusitis (IFRS). A 64-year-old woman was referred to our hospital due to persistent fever, headache, and rhinorrhea. After admission, her overall condition rapidly deteriorated, leading to a diagnosis of septic shock. Blood examination revealed elevated serum lactate dehydrogenase and soluble interleukin 2 receptor levels suggestive of ML. Computed tomography revealed a high-density area with calcifications within the sinus cavity. Although IFRS was the primary suspicion, subsequent endoscopic sinus surgery disconfirmed this hypothesis based on histological findings. Unfortunately, the patient succumbed to multiple organ failure 12 days after admission, with an autopsy confirming IVLBCL. It is crucial to consider IVLBCL as a potential differential diagnosis in cases involving fever of unknown origin and progressive deterioration of the general condition.