A nationwide analysis of acute ischemic stroke in intravascular large B-cell lymphoma: the needle in a haystack

Objective: A significantly increased risk of cerebrovascular disease (CVD) is well documented among patients diagnosed with various malignancies. Cancer patients face nearly double the risk of acute ischemic stroke (AIS) compared to the general population. Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive subtype of non-Hodgkin B-cell lymphoma characterized by the proliferation of neoplastic lymphoma cells within the vasculature of organs. Occurring in <0.5 per 1,000,000 persons, it is exceptionally rare. This study investigates AIS occurrence in IVLBCL patients. Methods: The National Inpatient Sample (NIS) was queried from the period of 2010–2019 using the International Classification of Diseases (ICD) 9th and 10th edition codes to identify patients admitted for AIS either with or without IVLBCL. Results: We identified 44 cases of IVLBCL among 705,928 AIS patients. We found that IVLBCL patients who experienced AIS were generally older (74.5 vs. 70.15 years, p < 0.0001), had less severe strokes (0.33 vs. 0.47, p < 0.01), longer hospital stays (12.22 vs. 5.99 days, p < 0.01), and received similar treatments compared to non-IVBCL AIS cases. Multivariate regression identified age at AIS admission, hypertension, and substance abuse as significant predictors of AIS in IVLBCL patients (all: OR > 1.0, p < 0.05). Conclusion: While limited by database constraints and IVLBCL’s rarity, this study highlights the potential link between IVLBCL and AIS. These findings not only emphasize the importance of vigilance and preventive measures in managing the health of cancer patients but also suggest potential avenues for enhancing patient care and outcomes.