Primary non-Hodgkin's lymphoma in the dorsolumbar muscles

Abstract

We report a case of primary soft tissue lymphoma with pulmonary involvement in a 57-year-old man, successfully treated with surgery and chemotherapy. The patient presented with a giant mass (16 ϫ 20 cm) in the left dorsolumbar region. Computed tomography (CT) demonstrated a right-sided pulmonary tumor, in addition to the giant tumor in the left dorsolumbar muscles. On an incisonal biopsy, the left dorsolumbar muscle tumor was suspected to be a sarcoma, and en-bloc resection was therefore performed. During surgery, four left pulmonary tumors that had not been observed on CT were found and surgically resected. The patient was finally diagnosed with soft tissue non-Hodgkin's B cell lymphoma with pulmonary involvement. After postoperative chemotherapy, the right pulmonary nodule disappeared. The patient was well and had no evidence of disease 22 months after surgery. To the best of our knowledge, primary soft tissue lymphoma is extremely rare.

Diagnosis of B‐cell lymphoma from gluteal muscle mass

“…Only Clinical examination and imaging results can lead to misdiagnosis of skeletal muscle lymphoma; however, added pathologic and immunohistological (IHC) analysis can lead to accuracy. Although fine needle aspiration (FNA) is of low cost, low complication, and simple to perform, it is only able to yield cytologic information, while the architecture of the tumor is also an important element to determine the histology . We carried out an excisional biopsy in this case but the diagnosis was mistaken perhaps, due to sampling inaccuracy that was obtained from fat over the fascia, while the mass was deep in the muscle, resulting in the inability of the IHC staining to detect lymphoma.…”