Acute Lower Limb Arterial Occlusion Due to Malignant Lymphoma.
Hana Isokawa, Hiroshi Abe, Dai Ozaki et al.
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Case in brief
A 72-year-old man presented with acute pain and weakness in the left lower limb and was diagnosed with arterial occlusion. Examination of the thrombectomy specimen identified fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL), although positron emission tomography-computed tomography showed no primary lesion. He later developed pneumonia while receiving radiotherapy for hypopharyngeal cancer and died. At autopsy, FA-DLBCL was found in a mural thrombus distal to an aortic stent graft.
What made this case unusual
The lymphoma was identified in an arterial thrombus despite no primary lesion being detected on imaging; autopsy localized it to mural thrombus distal to an aortic stent graft.
Diagnostic / clinical pearl
In acute limb ischemia with an atypical thrombus, pathological examination may reveal an underlying malignancy such as FA-DLBCL.