Adequacy of Single Random Skin Biopsy With Subcutaneous Sampling for the Diagnosis of Intravascular Lymphoma

Abstract

Background: Random skin biopsy (RSB) is a valuable method for diagnosis of intravascular lymphoma (IVL). Previous studies have performed RSB at multiple locations. This study aimed to evaluate the adequacy of a single RSB site and the appropriate depth of the biopsies for diagnosing IVL. Methods: The study included 209 patients who underwent RSB for IVL diagnosis. Sixty-six hematoxylin and eosin slides from 33 patients with a definitive diagnosis of IVL from RSB were analyzed for RSB site, blood vessel types, specimen depth, and tissue area containing detectable lymphoma cells. Results: Lymphoma cells were primarily detected in the capillaries of subcutaneous tissue (89.4%). The mean depth, tissue area of the specimens, and depth of the subcutaneous tissue were 12.7 mm, 151.2 mm², and 8 mm, respectively. There was no statistically significant difference in the sensitivity, specificity, positive predictive value, negative predictive value, or area under the receiver operating characteristic curve for lymphoma cell detection between RSBs obtained from the abdomen, thigh, or both locations. Conclusions: A single RSB location, either at the abdomen or thigh, is adequate for diagnosing IVL in most patients under appropriate conditions. Biopsied specimens should have adequate subcutaneous fat to increase the likelihood of detecting lymphoma cells.