Imaging features of skeletal muscle lymphoma: a case report and literature review

Abstract

Background Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL), occurring predominantly in older people. Skeletal muscle lymphoma is a rare form of DLBCL, most frequently affecting the thigh, upper extremities, calf, and pelvis. Case presentation We report a case of skeletal muscle DLBCL that was diagnosed using ultrasound (US)-guided biopsy. A 70-year-old man presented with progressive swelling and pain in the left lower extremity and an elevated erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP), ferritin, and CA125 levels. US, magnetic resonance imaging (MRI), and computed tomography (CT) showed diffuse lesions in several muscles of the left lower extremity. Positron emission tomography/CT (PET/CT) showed FDG-uptake in the affected muscles. The patient was treated with chemotherapy and achieved a good response. A systematic review of the literature published between 1992 and 2019 was conducted to investigate the role of imaging, including imaging-guided biopsy, in the diagnosis of skeletal muscle lymphoma. Conclusions Skeletal muscle lymphoma is rare. US and MRI features include enlargement of muscular structures, with preservation of the architecture of the tissue and surrounding anatomical structures. Definitive diagnosis relies on histological and immunohistological analysis of a sample obtained through imaging-guided biopsy.

Skeletal muscle dissemination in a dog with T‐cell lymphoma

“…The most common route of lymphomatous involvement of muscles is metastatic spread from adjacent lymph nodes or other structures (Chun et al., 2010 ; Suresh et al., 2008 ). In this case, the involvement of several lymph nodes may have favoured the invasion of more than one muscle compartment, as already described in human cases of lymphoma (Burton et al., 2017 ; Chun et al., 2010 ; Gao et al., 2021 ; Suresh et al., 2008 ).…”

Clinical Presentation and MRI Characteristics of Appendicular Soft Tissue Lymphoma: A Systematic Review

“…Margin descriptions of ASTL were heterogenous, ranging from poorly to well-defined. These findings are consistent with Gao et al as ASTL margins in MR imaging appear to be nonspecific [16]. This heterogeneity might be attributed to differences in subjective MRI interpretation between studies.…”

“…MRI is widely considered to be the imaging modality of choice to detect and differentiate between soft tissue masses [ 13 , 14 , 15 ]. However existing studies investigating MRI characteristics of ASTL are small scaled or consist of case series and case reports [ 16 ]. Moreover, investigation criteria among the existing studies are vastly heterogenous and differ in results.…”