Skin biopsy in the diagnosis of intravascular lymphoma: A retrospective diagnostic accuracy study

Background: The yield of skin biopsies in the evaluation of intravascular lymphoma (IVL) is largely unknown in Western patients. Most data supporting this test come from Asian populations, in which both prevalence and disease presentation seem to differ. Objective: To determine the yield and diagnostic properties of skin biopsy in the evaluation of IVL. Methods: We reviewed skin biopsy pathology reports of 50 patients being evaluated for IVL to calculate the diagnostic yield of this test. An additional 6 patients, who underwent skin biopsies after the diagnosis of IVL was made by other means, were included to calculate the sensitivity and specificity of our index test. Results: Skin biopsy samples were positive for 5 of the 50 patients being investigated for IVL. Sensitivity was 50% and specificity was 100%. Limitations: Only pathology reports containing IVL as an indication for the biopsy were retrieved. This might have excluded patients in whom the disease was considered but was not deemed likely enough to be listed as the indication for the test, inflating our estimative of skin biopsy yield. Conclusion: A relatively high diagnostic yield was found in the evaluation of IVL among patients with a diverse presentation in a Western hospital.