Intramural great vessel lymphoma presenting as thrombus in an aortic aneurysm

Intravascular large B-cell lymphoma (IVLBCL) is a subtype of extranodal B-cell lymphoma with growth limited to the lumina of small vessels. Intramural great vessel lymphoma (IMGVL), on the contrary, is extremely rare and there have been only two reported cases of primary B-cell lymphoma that occurred in the lumen of the superior vena cava and one case of primary B-cell lymphoma with intra-aortic growth, diagnosed at autopsy. We present the case of a 72-year-old man who presented with severe abdominal pain and was found to have thrombosed abdominal aortic aneurysm. The retrieved thrombus showed Epstein Barr virus-positive large B cell lymphoma (LBCL). Post-operative Echocardiography, Computerized tomography (CT) and Positron Emission Tomography (PET) scan did not show any residual tumor focus, abnormal mass or thickening, increased FDG uptake or hypermetabolism (Nodal or extranodal). This is the first case of large B cell lymphoma presenting as a thrombus within abdominal aortic aneurysm and third case of intramural great vessel lymphoma. Keywords: Lymphoma, Large B cell lymphoma, Aorta, Aneurysm, Intravascular large B cell lymphom