A case of intravascular large B-cell lymphoma left undiagnosed even by two random skin biopsies

We present a case of a 66-year-old man who initially presented with spinal cord lesions and was ultimately diagnosed with intravascular large B-cell lymphoma (IVLBCL) by autopsy after two inconclusive random skin biopsies (RSB). Prior steroid use may have contributed to the reduced diagnostic sensitivity of the skin biopsies. Given that brain and spinal cord biopsies are highly invasive, if IVLBCL of the central nervous system is strongly suspected for such reasons as elevated IL-10 in the cerebrospinal fluid, positron emission tomography (PET) may help identify non-neural or non-nervous organ lesions as the target of subsequent biopsies, potentially allowing the definite histological diagnosis when RSB are inconclusive.