Intravascular lymphomas are rare disease conditions that exhibit neoplastic lymphoid cells that are confined mainly to the lumens of small capillaries and medium-sized vessels. The majority of the intravascular lymphomas are of B-cell origin, but they can include NK/T-cell and CD30+ immunophenotypes. In the histologic differential diagnosis are benign proliferations such as intralymphatic histiocytosis and intravascular atypical CD30+ T-cell proliferation. In this review, we discuss the clinical, histopathologic, and molecular findings of intravascular B-cell lymphoma, intravascular NK/T-cell lymphoma, intralymphatic histiocytosis, and benign atypical intravascular CD30+ T-cell proliferation.

This commentary underscores the urgent issue of limited access to dermatologic care in rural areas, leading to adverse health outcomes. With only 10% of dermatologists practicing in rural America, the "rural mortality penalty" contributes to escalating morbidity and mortality. Disparities in dermatologist distribution, particularly in minority-majority counties with lower incomes, worsen health inequities. Despite these challenges, initiatives such as pipeline programs, rural university offices, rural dermatology residency tracks, teledermatology, and Project ECHO (a collaborative model of medical education and care) are promising. This commentary stresses the need for academic dermatologists to recruit more rural medical students and train more residents with a rural upbringing. This predicts future practice in such communities. Immediate action to address the widening rural dermatology gap is needed. The formation of the Rural Access to Dermatology Society, with its first meeting in the spring of 2024 at the annual meeting of the American Academy of Dermatology, is a key part of this process.