Diffuse large B-cell lymphoma in the psoas muscle

Abstract

DESCRIPTIONA 78-year-old man with a history of aphasia caused by cerebral infarction came to our hospital because of persistent progressive left lower back pain for 1 week, which had radiated through the left buttock and down the left thigh.On clinical examination, he was in the right lateral decubitus position on a bed in a psoas posture with a body temperature of 36.7°C. Laboratory results revealed leucocytosis (9.71×10 9 /L), and elevated lactate dehydrogenase (415 IU/L) and creatine kinase (255 IU/L) levels.Contrast-enhanced CT of the abdomen after plain CT revealed a swollen left psoas muscle that was enhanced homogeneously (figure 1, arrows), indicating tumours in the left psoas.A pathological examination of the left psoas muscle by CT-guided needle biopsy was conducted. H&E (figure 2) and additional immunohistochemical staining results ( positive for CD20, weakly positive for CD10, negative for CD3 and terminal deoxynucleotidyl transferase, and a high MIB-1 index) were consistent with diffuse large B-cell lymphoma (DLBCL).Although the primary origin of DLBCL was unclear, the left psoas muscle was most likely compared with the swollen lymph nodes in the perirenal space and para-aorta ventral to left psoas muscle because of its considerably large size.The patient's family requested only palliative care instead of chemotherapy due to the patient's advanced age and dementia. His clinical condition gradually deteriorated, he developed multiorgan system failure and died 43 days postadmission.Non-Hodgkin lymphoma (NHL) is the most common type of lymphoma 1

Diagnosis of B‐cell lymphoma from gluteal muscle mass

“…Lymphoma can originate in the lympho‐reticular tissue, within any part of the system, comprising of 10% of all malignant tumors and is divided into Hodgkin disease and non‐Hodgkin lymphoma (NHL) . NLH is the most common type of lymphoma and diffuse large B‐cell is its commonest subtype . Extranodal lymphoma refers to neoplastic proliferation of lymphocytes at sites other than native lymph node and lymphoid tissue .…”

Isolated skeletal muscle recurrence of an originally nodal diffuse large B cell lymphoma

“…The most common site of involvement is the extremities, with psoas, calf, gluteal, triceps muscle invasion being described in the literature. [ 2 , 3 , 5 , 6 ]…”

Primary skeletal muscle lymphoma with unusual soft tissue metastases in the stomach and pancreas detected by 18F-FDG PET/CT

“…Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphomas (NHL) [1], which usually arises from lymph nodes. It can also have an extra-nodal origin in approximately 30-40% of the cases [2].…”

“…The most common extra-nodal sites are testis, skin, lung, bone, central nervous system, respiratory and gastrointestinal tracts [3]. Primary skeletal muscle involvement is very rare [1][2][3]. It has also been reported that upper extremities and gluteal muscle involvements are more predominantly affected [1].…”

“…Primary skeletal muscle involvement is very rare [1][2][3]. It has also been reported that upper extremities and gluteal muscle involvements are more predominantly affected [1]. In muscular lymphoma which usually is FDG avid, diffuse enlargement or focal intramuscular mass are seen [4].…”