Primary Extranodal Soft Tissue Lymphoma of the Extremities

Travis, William D.; Banks, Peter M.; Reiman, Herbert M.

doi:10.1097/00000478-198705000-00004

Cited by 124 publications

(75 citation statements)

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“…Both of these tumors also may present as primary soft tissue tumors, however, very rarely (15)(16)(17). In children, intraosseous lymphoblastic lymphoma comprises a significant percentage of the lymphoma cases and is often misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

Differentiating Lymphoblastic Lymphoma and Ewing's Sarcoma: Lymphocyte Markers and Gene Rearrangement

et al. 2001

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We encountered a child with an intraosseous small round cell tumor that was negative for LCA, CD20 (L26), and CD3 and positive for vimentin, CD99 (MIC-2), and periodic acid-Schiff. The tumor exhibited rosette-like formations. This case was initially interpreted as Ewing's sarcoma (ES); however, additional studies revealed positivity for CD79a, CD43, and TdT expression, and an immunoglobulin heavy chain gene rearrangement (IgH-R) by polymerase chain reaction (PCR) established this to be a precursor B-lymphoblastic lymphoma. Because the differential diagnosis of ES and lymphoblastic lymphoma can be difficult and the differential diagnostic value of leukocyte antigens and immunoglobulin heavy chain gene rearrangement studies have not been fully evaluated, we conducted a more extensive investigation on 33 (21 soft tissue and 12 intraosseous) ES cases. Cases were retrieved from the files of the Department of Pathology at Georgetown University and from the Soft Tissue Registry of the Armed Forces Institute of Pathology. The cases were studied by light microscopy, immunohistochemistry, and PCR for IgH-R and T cell receptor gamma chain gene rearrangement (T␥-R). There were 17 females and 16 males; the mean age was 29.3 years. Locations included the extremities (n ‫؍‬ 17) and trunk (n ‫؍‬ 16). All cases fit the ES spectrum by light microscopy and immunohistochemistry, as previously determined, and were negative for lymphoid markers (LCA, CD3, CD20, CD43, CD79a, and TdT), CD10 and CD34. CD99 was positive in 31/33 and bcl-2 was weakly positive in 13/33 cases. All 21 cases studied for gene rearrangements by PCR were negative for IgH-R and T␥-R. Distinction of intraosseous lymphoblastic lymphoma from ES may be difficult because lymphomas may occasionally exhibit unexpected morphologic and immunophenotypic properties including LCA, CD3 and CD20 negativity and cytokeratin positivity. Additional analysis using CD79a, CD43, TdT, and PCR should be performed to avoid misdiagnosis. True ES is negative for lymphoid markers including CD79a, CD43, and TdT, as well as for IgH-R and T␥-R.

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Section: Discussionmentioning

confidence: 99%

Differentiating Lymphoblastic Lymphoma and Ewing's Sarcoma: Lymphocyte Markers and Gene Rearrangement

et al. 2001

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“…To our knowledge, there were only 2 reports of canine presumed pSML [6,14]. In human medicine, pSML is also less common and represents only 8 cases of 7000 consecutive patients with primary soft tissue lymphoma [15]. Similarly, another study shows only 8 cases of pSML in over 6000 non-Hodgkin's lymphomas (NHLs) registered with the Scotland and Newcastle Lymphoma Group over a 15-year period [11].…”

mentioning

confidence: 97%

“…In human medicine, the most common hypothesis is that extranodal lymphoma arises secondary to chronic inflammation [7,8]. Human skeletal muscle lymphoma tends to occur in the extremities, especially in the lower extremities [1,8,15]. One of the reasons may be that the extremities are vulnerable to injuries [1,8], and there are some reports of human pSML occurring after leg injury [10,12,13] and presenting near the injection site of drugs [2].…”

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confidence: 99%

Long Term Survival of Primary Skeletal Muscle Lymphoma in a Miniature Dachshund

Takeuchi

Fujino

Goto‐Koshino

et al. 2010

The Journal of Veterinary Medical Science

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ABSTRACT. An 8-year-old miniature dachshund presented with a right femoral muscle mass and anorexia. Cytology of the mass revealed a number of small-sized lymphoid cells containing a pleomorphic-shaped dense nucleus and narrow pale cytoplasm. Histopathology indicated that neoplastic lymphoid cells proliferated in skeletal muscles and replaced the muscular architecture. Immunohistochemical and genetic examinations confirmed the diagnosis of primary skeletal muscle lymphoma classified as the pleomorphic small cell type and Tcell low-grade. Although the dog suffered at least three relapses by combination chemotherapy, the dog survived 713 days after the initial presentation.

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“…There are a few reports describing the MR imaging findings of lymphoma in the soft tissue of the extremities (1,17): a large soft tissue mass with equal to slightly low signal intensity on T1-weighted images and markedly high signal intensity on conventional T2-weighted images, without osseous involvement, but with infiltration of skeletal muscle and surrounding soft tissues was observed. Therefore, Lee et al (17) recommend that, at MR imaging, if a large soft-tissue mass with normal adjacent bone marrow or a mass more extensive than the adjacent bone marrow abnormalities that affects a long segment of an extremity with diffuse muscle involvement is observed, and there is the presence of subcutaneous stranding or extension, the differential diagnosis should include and favor primary soft tissue lymphoma in the absence of a history of trauma or infection.…”

Section: Discussionmentioning

confidence: 99%

“…Non-Hodgkin lymphoma (NHL) arising from the soft tissue of the extremities is rare (1), and its clinical manifestation and defects observed on magnetic resonance imaging and computed tomography are characteristic features. In this study, we describe a 68-year-old female with primary extranodal NHL of the right thigh, which was amputated.…”

Section: Introductionmentioning

confidence: 99%

Primary giant lymphoma of the right thigh: A case report and brief review of the literature

Gao

Wei

et al. 2012

Oncology Letters

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Abstract. Primary soft tissue non-Hodgkin lymphoma (NHL) of the extremities is very rare. The clinical features of NHL mimic those of other soft tissue tumors, particularly sarcoma; however, they should be differentiated, as the treatment and prognosis are completely different. In this study, the case of a 68-year-old female with a giant mass, movement disorder, numbness and painful sensations in the right thigh is presented. Magnetic resonance (MR) imaging revealed a huge circle-shaped mass. Fine needle aspiration cytology (FNAC) of the tumor demonstrated neoplastic small, round cells. The tentative diagnosis was of a mesenchymal sarcoma. The right thigh was amputated. On histological examination of the amputated extremity, the diagnosis was found to be large B cell lymphoma. Primary soft tissue NHL of the extremities is a systemic malignant disease and is sensitive to chemotherapy and radiotherapy. The histological diagnosis should be identified as far as possible before the tumor is widely excised.

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Primary Extranodal Soft Tissue Lymphoma of the Extremities

Cited by 124 publications

References 0 publications

Differentiating Lymphoblastic Lymphoma and Ewing's Sarcoma: Lymphocyte Markers and Gene Rearrangement

Differentiating Lymphoblastic Lymphoma and Ewing's Sarcoma: Lymphocyte Markers and Gene Rearrangement

Long Term Survival of Primary Skeletal Muscle Lymphoma in a Miniature Dachshund

Primary giant lymphoma of the right thigh: A case report and brief review of the literature

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