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Unusual association of diseases/symptoms
CASE REPORT
Intravascular lymphoma presenting with postural hypotension
  1. Catharine Pearce1,
  2. Suzy Hope1,2,
  3. Joseph Butchart1
  1. 1 Healthcare for Older People Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  2. 2 Diabetes and Vascular Research Centre, University of Exeter Medical School, Exeter, UK
  1. Correspondence to Dr Suzy Hope, S.V.Hope{at}exeter.ac.uk, suzyvhope{at}yahoo.co.uk

Summary

An 84-year-old woman presented with severe postural hypotension. Further assessment revealed weight loss, fatigue and fever at night. On examination, she had bilateral skin lesions on the inner thighs and skin biopsy revealed intravascular high grade B cell lymphoma. This was successfully treated with curative chemotherapy. The cause of the postural hypotension in this case was felt likely to be autonomic neuropathy caused by neurovascular infiltration by intravascular lymphoma. Treatment of the lymphoma has resolved the postural hypotension, although some symptoms of postural instability persist.

  • geriatric medicine
  • haematology (incl blood transfusion)
  • adrenal disorders
  • dermatology

https://doi.org/10.1136/bcr-2017-221803

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    Footnotes

    • Contributors All authors were involved in the conception and design of the article after caring for this patient on admission to hospital as detailed in the report. CP subsequently acquired the initial patient information and wrote the first draft of the clinical aspects of the case; this was revised by SVH who also wrote the first draft of the literature review. CP and JB obtained follow-up information regarding the patient and JB critically reviewed and revised the manuscript. SVH finalised the manuscript. All authors approved the final submitted version and also agreed to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.