Intravascular large B-cell lymphoma masked by multinodular goiter of the thyroid: a case report and diagnostic pitfall
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By
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Guona Zheng
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Lei Xu
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Lili Peng
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Tingting Liu
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Lin Kang
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Huanfen Zhao
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July 16, 2026
Clinical Scorecard: Intravascular Large B-Cell Lymphoma Concealed by Multinodular Goiter: A Case Study Highlighting Diagnostic Challenges
At a Glance
| Category | Detail |
|---|
| Condition | Intravascular Large B-Cell Lymphoma (IVLBCL) |
| Key Mechanisms | Proliferation of neoplastic B-lymphoid cells within small and medium-sized blood vessels, especially capillaries. |
| Target Population | Patients with thyroid nodular goiter and suspected malignancy. |
| Care Setting | Pathological diagnosis and oncology treatment. |
Key Highlights
- IVLBCL is a rare and aggressive malignancy with multi-organ involvement.
- Diagnosis is challenging due to atypical presentation and lack of classic lymphoma signs.
- The case highlights the risk of missed diagnosis in junior pathologists.
Guideline-Based Recommendations
Diagnosis
- Consider IVLBCL in patients with thyroid nodular goiter and atypical findings.
Management
- Initiate standardized chemotherapy upon diagnosis.
Monitoring & Follow-up
- Monitor for circulating tumor cells as biomarkers for tumor progression.
Risks
- High risk of missed diagnosis due to atypical growth patterns.
Patient & Prescribing Data
63-year-old female with bilateral goiter and suspected malignant lesions.
Bilateral thyroidectomy and lymph node dissection were performed.
Clinical Best Practices
- Pathologists should be aware of IVLBCL's atypical presentation.
- Re-examination of suspicious cases by senior pathologists is recommended.
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