MRI Features of Skeletal Muscle Lymphoma

Chun, Chang Woo; Jee, Won-Hee; Park, Hye Jung; Kim, Yeo Joo; Park, Jeong-Mi; Lee, Sanghoon; Park, Sung-Hwan

doi:10.2214/ajr.09.3904

Cited by 58 publications

(65 citation statements)

References 13 publications

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“…The patient's MR images showed an intrinsic bright fat signal (fatty atrophy) of all muscles, and a disorganized internal architectural pattern, a pattern not typically observed with metastatic carcinoma to muscle. A similar pattern of muscle enlargement and loss of normal fatty marbling was described by Chun et al [7], and can be seen with lymphoma, although there is typically asymmetric muscle enhancement in the affected muscles without a discrete mass. The possible appearances of metastatic carcinoma masses to muscle were discussed by Tuoheti et al [53], in which some metastatic masses show isosignal intensity with poorly defined margins on T1-weighted imaging.…”

Section: Discussionsupporting

confidence: 73%

Orthopaedic Case of the Month: A 72-year-old Man With a Painful Flexion Contracture of the Left Thigh

Cafferky

Malone

Bowen

2013

Clinical Orthopaedics &Amp; Related Research

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A 72-year-old man presented with a 48-hour history of increasing left posterior thigh pain and a progressive left knee flexion contracture. Physical examination revealed that he recently had a left below knee amputation. The stump was healing well. He had a firm posterior thigh with a woody consistency extending from the popliteal fossa proximally to the midposterior left thigh. On attempted passive extension of the left knee, there was exquisite pain in the posterior thigh.Four weeks before his current presentation for the left posterior thigh pain, he had been admitted to our institution with a 1-week history of worsening abdominal pain, nausea, and vomiting. The patient had general surgery and gastroenterology consultations. Physical examination of his abdomen revealed a soft, nondistended abdomen with hyperactive bowel sounds. He had tenderness in the epigastrium, umbilical region, and right lower quadrant. There were no palpable masses or organomegaly. Imaging of the abdomen revealed a high-grade small bowel obstruction with a transition point seen in the right lower quadrant. The patient was treated with a small bowel follow-through and colonoscopy that led to an exploratory laparotomy with resection of a mass in the distal ileum. Pathologic examination of the small bowel mass showed a metastatic Stage IV carcinoma. Further immunohistochemical and tumor marker analyses suggested a primary neoplasm of gastric or esophageal origin. Staging with a CT of the chest, abdomen, and pelvis showed no other lesions of the viscera.During the same hospital admission for his small bowel obstruction, orthopaedics was consulted for a chronic 4-cm 9 2-cm wound of the left heel that had been present for 6 months. On evaluation, he also had chronic osteomyelitis of the left calcaneus and a left knee flexion contracture of 30°with mild tenderness to palpation about the knee. Radiographs of the left knee showed chronic degenerative changes. No additional or advanced imaging of his left knee or thigh was obtained at that time, as he had a relatively painless knee flexion contracture. His surgical history revealed that 2 years before his current presentation he had undergone a left Chopart amputation for dysvascular forefoot wounds. Although he did not have a diagnosis of diabetes, he had a history of peripheral vascular disease with neuropathy secondary to heavy tobacco use. As treatment for his chronic heel wound, the patient underwent a left below knee amputation 5 days after his exploratory laparotomy. Intraoperatively after the below knee amputation, he was treated with an intraarticular

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Section: Discussionsupporting

confidence: 73%

Orthopaedic Case of the Month: A 72-year-old Man With a Painful Flexion Contracture of the Left Thigh

Cafferky

Malone

Bowen

2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…The initial manifestations are typically abnormal muscle signal intensity and muscle enlargement. Generally, the neoplasms have slightly increased signal intensities compared with normal muscles on T1-weighted images and intermediate signal intensities compared with fat tissues on T2-weighted images (28). In addition, fine-needle aspiration (FNA) biopsy is normally conducted.…”

Section: Discussionmentioning

confidence: 99%

Anaplastic large cell lymphoma with primary involvement of the skeletal muscle: A case report

et al. 2015

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Abstract. The present study reported the case of a patient with primary anaplastic large cell lymphoma (ALCL) occurring in the left major psoas. A 24-year-old male patient presented with one-month history of left lower back pain, which had been exacerbated for 10 days prior to admission. Magnetic resonance imaging (MRI) scans revealed an enlarged major psoas muscle that protruded into the inguinal region. The presence of an intense soft tissue mass on MRI scans, as well as the results of fine-needle aspiration biopsy and immunohistochemical analysis of the mass, may help establish an early diagnosis, allowing for the appropriate treatment strategy to be initiated.

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“…B-cell, T-cell, natural killer cell, and other types of non-Hodgkin lymphoma are most likely to present as a soft tissue mass; Hodgkin lymphoma is unlikely to do so [ 80 ]. The soft tissue mass often crosses fascial planes and surrounds, rather than displaces, adjacent vessels [ 81 ]. Distal limb swelling and subcutaneous edema may result [ 80 ].…”

Section: Lymphoma/leukemia Lymphomamentioning

confidence: 99%

“…On MRI, lymphoma of the soft tissues appears as an infi ltrative mass, crossing fascial planes and a b surrounding, rather than displacing, neurovascular structures [ 81 ]. The mass has intermediate to high signal on T2-W imaging and intermediate signal on T1 [ 79 , 81 ].…”

Section: Lymphoma/leukemia Lymphomamentioning

confidence: 99%

Soft Tissue Masses

Roper

Stein-Wexler

2014

Pediatric Orthopedic Imaging

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The chapter is divided in two parts: the fi rst part discusses benign masses and the second addresses malignancies. Vascular lesions are discussed, differentiating between high-fl ow and low-fl ow lesions. Fatty lesions, neurofibromas, tumoral calcinosis, and myositis ossifi cans are described in detail, and hematomas, popliteal cysts, and other lesions are presented more briefl y. The following section on malignant masses focuses on sarcomas and other fi brous tumors. The discussion of sarcomas includes infantile fi brosarcoma, synovial sarcoma, rhabdomyosarcoma, lymphoma/leukemia, as well as lesions such as epithelioid sarcoma, granulocytic sarcoma, liposarcoma, extraskeletal Ewing sarcoma/osteosarcoma, and hemangiopericytoma.

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MRI Features of Skeletal Muscle Lymphoma

Abstract: Skeletal muscle lymphoma has distinctive MRI features that help differentiate it from other soft-tissue tumors and tumorlike lesions.

Cited by 58 publications

References 13 publications

Orthopaedic Case of the Month: A 72-year-old Man With a Painful Flexion Contracture of the Left Thigh

Orthopaedic Case of the Month: A 72-year-old Man With a Painful Flexion Contracture of the Left Thigh

Anaplastic large cell lymphoma with primary involvement of the skeletal muscle: A case report

Soft Tissue Masses

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