A rare case of primary muscular non-Hodgkin’s lymphoma and a review of how imaging can assist in its diagnosis

Abstract

Primary malignant non-Hodgkin's lymphoma of the muscle is rare. Currently, imaging tools are necessary to enable its diagnosis. Herein, we report the case of a patient who presented with swelling and pain in the right thigh and pelvis. Computed tomography findings revealed isodense masses in the patient's right thigh and left iliacus muscle, leading to the initial diagnosis of either primary muscular lymphoma or soft tissue sarcoma. Further investigation with magnetic resonance imaging was done, and a biopsy was performed. The ensuing histological diagnosis was that of diffuse large B-cell lymphoma.

Skeletal Muscle Involvement in B-Cell Lymphoma: Two Cases Illustrating the Contribution of Imaging to a Clinically Unsuspected Diagnosis

“…Our patients' imaging findings correspond well with those described in the literature [7, 8, 10–13]. In a recent retrospective study, Chun et al [14] assessed MRI findings from 20 biopsy-proven cases of muscle lymphoma.…”

“…It typically presents with a mass, swelling, and pain [10]. As imaging is often part of the initial workup, radiologists have the opportunity to direct further evaluation by suggesting the diagnosis.…”

Diagnosis of B‐cell lymphoma from gluteal muscle mass

“…Extranodal lymphoma refers to neoplastic proliferation of lymphocytes at sites other than native lymph node and lymphoid tissue . Extranodal involvement of NHL is approximately 20%‐30% . Primary extranodal, located only on the extranodal site, commonly arise from gastrointestinal tract whereas, primary skeletal muscle non‐Hodgkin's lymphoma (PSM NHL) is rare, and constitutes up to 0.1 to 0.5% of NHL .…”

Skeletal Muscle Diffuse Large B-Cell Lymphoma in the Gluteal Region

“…Magnetic resonance imaging may aid in diagnosis and enables evaluation of tumor extension and adjacent structure involvement. However, histological analysis and immunohistochemistry is necessary to confirm the diagnosis [ 10 ].…”