# Recurrent fever, persistent cytopenia

**Authors:** 祎 缪, 菁 张, 涵 张, 重阳 丁, 震 王, 忠兰 苏, 建勇 李, 文瑜 施

PMC · DOI: 10.3760/cma.j.cn121090-20241129-00492 · 2025-09-01

## TL;DR

This paper presents a case of a rare type of lymphoma with recurring fever and blood cell reduction, highlighting the challenges in diagnosis and treatment.

## Contribution

The paper provides a clinical case study of IVLBCL with multidisciplinary insights to improve future diagnosis and treatment strategies.

## Key findings

- The patient was diagnosed with IVLBCL after multiple tests and biopsies.
- Despite R-CHOP treatment, the disease progressed rapidly, leading to the patient's death.
- The case emphasizes the importance of multidisciplinary collaboration in managing IVLBCL.

## Abstract

血管内大B细胞淋巴瘤（IVLBCL）是一种罕见类型的大B细胞淋巴瘤。本文报道了一例因“反复发热、全血细胞减少”就诊的病例。患者，女，64岁，既往诊断华氏巨球蛋白血症，曾接受泽布替尼治疗。2023年2月因“反复发热、全血细胞减少”就诊，PET-CT示双侧肾上腺明显肿大，经肾上腺穿刺活检诊断为弥漫大B细胞淋巴瘤，非特指型。患者接受R-CHOP（利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松）方案化疗，3个疗程后经头颅MRI检查提示淋巴瘤中枢神经系统浸润。回顾病理检查，最终诊断为IVLBCL。尽管积极治疗，但患者疾病持续进展，于2个月后死亡。本文基于多学科层面，结合该病例，从多学科团队协作角度展开论述，旨在为IVLBCL的临床诊疗提供参考意见。

## Full-text entities

- **Diseases:** pancytopenia (MESH:D010198), cytopenia (MESH:D006402), fever (MESH:D005334), lymphoma (MESH:D008223), diffuse large B-cell lymphoma (MESH:D016403), Waldenstrom's macroglobulinemia (MESH:D008258), IVLBCL (MESH:D016393)
- **Chemicals:** cyclophosphamide (MESH:D003520), prednisone (MESH:D011241), zanubrutinib (MESH:C000629551), R-CHOP (-), rituximab (MESH:D000069283)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12580801/full.md

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Source: https://tomesphere.com/paper/PMC12580801