Arborising telangiectasia in intravascular large B‐cell lymphoma

Arborising telangiectasia in intravascular large B-cell lymphomaA 62-year-old female presented to the Endocrinology Department with intermittent fever and progressive oedema for 7 months.She had noticed the appearance of telangiectasia on the skin of both thighs, abdomen, back and breasts and accepted laser therapy ineffectively.Physical examination revealed arborising telangiectasia of the lower extremities, the abdomen, back and both breasts (left image).Examination was otherwise unremarkable.Parameters of acute inflammation were increased, with C-reactive protein, 21.25 mg/L [reference value: <8 mg/L]; ferritin, 1222 ng/mL [reference value: 14-307 ng/mL]; and Interleukin-10, 144 pg/mL [reference value: <9.1 pg/mL].Further investigations revealed hypofunction of the anterior pituitary gland with low levels of free thyroxine, total thyroxine, thyroid-stimulating hormone, luteinising hormone and follicle-stimulating hormone.Pulmonary function tests showed isolated diffusion impairment, and Magnetic Resonance Imaging (MRI) showed nonhomogeneous enhancement in the anterior pituitary lobe (MRI, right top panel).