This case illustrates four critical teaching points: (1) intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of DLBCL; (2) isolated lymph node involvement is exceptionally uncommon in reported cases; (3) the absence of typical cutaneous or central nervous system involvement further complicates the diagnosis; and (4) its occurrence in an HIV-positive patient represents a particularly unusual clinical scenario. Early recognition of these atypical features, together with prompt combined antiretroviral and chemotherapy, achieved complete remission despite profound immunosuppression, highlighting the need for vigilant and individualized management in such rare and diagnostically challenging presentations.
Zhang et al. (2026) studied this question.