Usefulness of 20-mm incisional random skin biopsy for diagnosis of intravascular large B-cell lymphoma: a single-center experience

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of aggressive non-Hodgkin lymphoma characterized by the preferential proliferation of lymphoma cells within small vessels. Random skin biopsy (RSB) has been reported as a useful diagnostic tool for IVLBCL, although its sensitivity varies across studies. We retrospectively evaluated the efficacy and safety of the RSB method used at our institution. Between January 2022 and April 2026, 15 patients underwent RSB. Spindle-shaped incisions approximately 20 mm in length were made to obtain skin specimens containing subcutaneous fat. Six patients were diagnosed with IVLBCL by RSB. In most cases, IVLBCL cells were identified within vessels in the subcutaneous fat. Wider specimens contained a greater number of IVLBCL lesions. Hematoma formation occurred in one patient after RSB, and was successfully managed with supportive care. Our RSB method may facilitate the prompt diagnosis and treatment of patients suspected of having IVLBCL.