Skin biopsy in the diagnosis of intravascular lymphoma: A retrospective diagnostic accuracy study - 08/07/21

Doi : 10.1016/j.jaad.2019.09.015

Daniel Rozenbaum, MD ^a, Joe Tung, MD ^b,^c, Yun Xue, MD ^c, Mai P. Hoang, MD ^b,^d, Daniela Kroshinsky, MD, MPH ^b,^c,^⁎
^a Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
^b Harvard Medical School, Boston, Massachusetts
^c Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
^d Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts

^∗Reprint requests: Daniela Kroshinsky, MD, MPH, MGH Medical Dermatology, Massachusetts General Hospital, 50 Staniford St, Ste 200, Boston, MA 02114.MGH Medical DermatologyMassachusetts General Hospital50 Staniford StSte 200BostonMA02114

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Abstract

Background

The yield of skin biopsies in the evaluation of intravascular lymphoma (IVL) is largely unknown in Western patients. Most data supporting this test come from Asian populations, in which both prevalence and disease presentation seem to differ.

Objective

To determine the yield and diagnostic properties of skin biopsy in the evaluation of IVL.

Methods

We reviewed skin biopsy pathology reports of 50 patients being evaluated for IVL to calculate the diagnostic yield of this test. An additional 6 patients, who underwent skin biopsies after the diagnosis of IVL was made by other means, were included to calculate the sensitivity and specificity of our index test.

Results

Skin biopsy samples were positive for 5 of the 50 patients being investigated for IVL. Sensitivity was 50% and specificity was 100%.

Limitations

Only pathology reports containing IVL as an indication for the biopsy were retrieved. This might have excluded patients in whom the disease was considered but was not deemed likely enough to be listed as the indication for the test, inflating our estimative of skin biopsy yield.

Conclusion

A relatively high diagnostic yield was found in the evaluation of IVL among patients with a diverse presentation in a Western hospital.

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Key words : clinical research, diagnostic accuracy, intravascular B-cell lymphoma, intravascular lymphoma, medical dermatology, sensitivity, skin biopsy, specificity, yield

Abbreviations used : HLH, IVL

Plan

Methods

Data collection

Index test and reference standard

Skin biopsy characteristics

Diagnostic accuracy

Clinical presentation of IVL

Discussion

Conclusions

	Daniel Rozenbaum, MD, and Joe Tung, BS, are cofirst authors.
	Funding sources: None.
	Conflicts of interest: None disclosed.
	IRB approval status: Reviewed and approved by Partners Human Research Committee/IRB approval #2018P000936.