Lymphoma. Presenting as an intramuscular small cell malignant tumor

Kandel, Rita A.; Bédard, Yvan C.; Pritzker, Kenneth P.H.; Luk, S. C.

doi:10.1002/1097-0142(19840401)53:7<1586::aid-cncr2820530727>3.0.co;2-z

Cited by 51 publications

(22 citation statements)

References 8 publications

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“…32 The criteria for a primary soft-tissue sarcoma are an absence of lymphoma elsewhere, an absence of lymph nodes in the area, [33][34][35] and (according to some authors) no evidence of recurrence or spread three months after the diagnosis. 33 Although these criteria were not fulfilled in this case, the clinical course strongly suggests that the tumor originated in soft tissue.…”

Section: Pathological Discussionmentioning

confidence: 99%

Case 11-1999

Freedman¹,

Nielsen²

1999

N Engl J Med

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A 60-year-old woman was admitted to the hospital because of lumbar pain and incontinence of the bladder and bowel.She had a 20-year history of low back pain with radiation to the buttocks and anterior thighs, for which she took nonsteroidal antiinflammatory drugs. Three months before admission, she had a bout of back pain that persisted. One month before admission, the patient entered another hospital because for several weeks she had had bladder and bowel incontinence, leg weakness, and severe pain in the thighs on attempting to stand.A computed tomographic (CT) scan of the lumbar spine ( Fig. 1) showed abnormal epidural and paraspinal soft-tissue masses at the L4 level and within the sacral spinal canal and the possible presence of such tissue within the sacral alae. The findings on a chest radiograph and a radionuclide bone scan were normal. A CT scan of the abdomen and pelvis revealed a left renal mass, 1.5 cm in diameter, and a right renal mass, 1 cm in diameter, that could not be further characterized. There were bilateral renal cysts and a right adnexal cyst.Treatment with dexamethasone was begun. Needle biopsy of the lower spine on two occasions showed no evidence of tumor. Because of the strong possibility of metastatic tumor growth, a course of 10 fractions of palliative radiation was administered to the lumbosacral spine but had no effect on the pain or incontinence. The patient had intermittent fever, the cause of which was not discovered, although a repeated radiograph of the chest showed a questionable left-sided pulmonary infiltrate.Antibiotics were given intravenously, with transient improvement. Findings on microscopical ex-amination of a bone-marrow specimen were normal. The patient was sent home, where she became weaker. Two days before admission to this hospital, her temperature rose to 39.4°C, with chills and confusion. She was readmitted to the other hospital, where a CT scan of the chest showed a necrotic cavitating mass in the periphery of the right lung; the bilateral renal lesions of low attenuation appeared to have increased in size. Fluids and ceftazidime were administered, and the fever promptly resolved. The patient was transferred to this hospital.The patient had a 35-pack-year history of cigarette smoking but had stopped smoking five years before admission. The aortic valve had been replaced two years before admission, and a demand pacemaker had been implanted because of a surgical complication during the replacement procedure. She had anorexia and had lost 9 kg in weight during the three months before admission. She took warfarin and quinidine regularly and took prophylactic amoxicillin for dental procedures. There was no history of trauma, dyspnea, chest pain, cough, sputum production, or hemoptysis.The temperature was 36.5°C, the pulse was 102, and the respirations were 20. The blood pressure was 110/70 mm Hg. On physical examination, the patient was thin and appeared to have a chronic ill-Figure 1. CT Scan of the Lumbar Spine Obtained One Month before Admission. A soft-tissue m...

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Section: Pathological Discussionmentioning

confidence: 99%

Case 11-1999

Freedman¹,

Nielsen²

1999

N Engl J Med

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“…The patient's past history was unremarkable. [2][3][4][5] Therefore, some cases of lymphoma may be misdiagnosed as undifferentiated tumor, and the true incidence of soft-tissue lymphoma may be underestimated. However, computed tomography (CT) and magnetic resonance imaging (MRI) showed a right-sided pulmonary nodule, in addition to the large soft tissue mass in the left dorsolumbar muscles (Fig.…”

Section: Case Reportmentioning

confidence: 99%

“…However, computed tomography (CT) and magnetic resonance imaging (MRI) showed a right-sided pulmonary nodule, in addition to the large soft tissue mass in the left dorsolumbar muscles (Fig. [2][3][4][5] Treatment strategies for patients with soft-tissue lymphoma have not been consistent. Additional workup, including an abdominal CT and bone and gallium scintigraphy, did not show any other tumors.…”

Section: Case Reportmentioning

confidence: 99%

Primary non-Hodgkin's lymphoma in the dorsolumbar muscles

Yamada

Shikata

Yamazaki

et al. 1999

International Journal of Clinical Oncology

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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.

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“…Muscle enlargement may be due to a variety of benign conditions, such as exercise hypertrophy, infection, hemorrhage, myxoma and autoimmune diseases, and malignant conditions, including cancer metastasis and primary sarcoma or lymphoma (1).…”

Section: Introductionmentioning

confidence: 99%

“…The most frequent among these diseases are primary bone lymphomas, accounting for 3-5% of all bone tumors and 5% of all primary extranodal non-Hodgkin lymphomas (NHLs) (2). Three mechanisms of lymphomatous involvement of the muscle have been described: Direct invasion from adjacent involved lymph nodes or bone, metastatic spread and, least commonly, primary muscle lymphoma (1,3). The treatment of primary skeletal muscle lymphoma relies predominantly on the type of lymphoma and the prognosis of primary skeletal muscle lymphoma is generally poor (4).…”

Section: Introductionmentioning

confidence: 99%

Primary skeletal muscle lymphoma: A case report

et al. 2017

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Abstract. Primary lymphomas of the bone or skeletal muscle are rare. Three mechanisms of lymphomatous involvement of the muscle have been described, namely direct invasion from adjacent involved lymph nodes or bone, metastatic spread and, least commonly, primary muscle lymphoma. We herein present a rare case of primary mucle non-Hodgkin lymphoma with a description if the associated clinicopathological findings and a review of the relevant literature. A 41-year-old female patient was referred to our hospital with a painful mass in the right lower extremity. Following resection and histopathological examination, a diffuse large B-cell lymphoma originating from the muscle with cutaneous and subcutanenous infiltration was diagnosed. The patient received chemotherapy with six cycles of cyclophosphamide, hydroxydaunomycin, oncovin and prednisone (CHOP regimen) and a complete radiological response was achieved after six cycles of treatment.

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Lymphoma. Presenting as an intramuscular small cell malignant tumor

Cited by 51 publications

References 8 publications

Case 11-1999

Case 11-1999

Primary non-Hodgkin's lymphoma in the dorsolumbar muscles

Primary skeletal muscle lymphoma: A case report

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