Lymphome non Hodgkinien intramusculaire primitif chez le sujet jeune: à propos d’un cas et revue de la littérature

Majdoul, Soufya; Omari, Nabil; Allali, Youness; Ghabri, Reda; Benchakroun, Nadia; Fadili, Mostafa; Tawfiq, N.; Jouhadi, H.; Sahraoui, S.; Nechad, Mohamed; Benider, Abdellatif

doi:10.11604/pamj.2016.25.223.10600

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…In skeletal muscle NHL, the tumor and its swelling may spread from one compartment to other adjacent compartments, sometimes leading to compartment syndrome, severe electrolyte disorders, acidosis, and rhabdomyolysis similar to what was seen in our patient, but our case is unique as it is found in a young patient with HIV [7]. Diagnosis can usually be made via an MRI or a PET scan, which shows a diffuse enlargement of the involved muscle and adjacent organs and increased metabolisms at the muscle level.…”

Section: Discussionsupporting

confidence: 69%

A Rare Case of Aggressive Non-Hodgkin's Lymphoma of the Muscle in a Young Male Presenting as Necrotizing Myofasciitis

Mehta,

Iqbal,

Akella

et al. 2024

Cureus

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Non-Hodgkin's lymphoma (NHL) involving skeletal muscle is generally found to be a secondary metastasis and extremely rarely as a primary site of malignancy. Furthermore, in HIV patients, an increased incidence of lymphomas may be identified within the first six months of highly active antiretroviral therapy (HAART) initiation unmasked by immune reconstitution inflammatory syndrome (IRIS). We illustrate an extremely rare instance of NHL of the skeletal muscle in a young immunocompromised male with HIV/AIDS presenting as necrotizing myofasciitis complicated by compartment syndrome and hemodialysis-refractory type B lactic acidosis.A young Hispanic male with AIDS was admitted for acute left thigh pain and was soon found to have abscess formation with compartment syndrome requiring thigh fasciotomy. During the course of the ICU stay, the patient's clinical status acutely worsened with sepsis-induced multiorgan failure, including acute renal and acute liver failure requiring N-acetylcysteine and severe refractory metabolic acidosis requiring renal replacement therapy. Repeat imaging demonstrated diffuse myonecrosis. Left thigh muscle biopsy confirmed aggressive NHL of skeletal muscle. Despite months of arduous medical management in ICU, doxorubicin, vincristine, cyclophosphamide chemotherapy with concurrent high-dose prednisone for the vented patient, and intermittent curves of improvement, our patient succumbed to the nature of the disease and subsequently died from severe sepsis from the immunocompromised state.Interestingly, our patient's initial CD4 count was 1, which improved to 96 after five months of HAART, raising concerns for IRIS lymphoma. Given such rapid improvement with chemotherapy, the possibility of IRIS-related lymphoma, and the surprising dearth of data for chemotherapy use in critically ill patients on mechanical ventilation, more research is needed in these topics to better approach such complicated patients.

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Section: Discussionsupporting

confidence: 69%

A Rare Case of Aggressive Non-Hodgkin's Lymphoma of the Muscle in a Young Male Presenting as Necrotizing Myofasciitis

Mehta,

Iqbal,

Akella

et al. 2024

Cureus

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“…Faced with clinical signs suggestive of tumor malignancy, a thoracoabdominal CT scan was performed as part of the extension assessment which revealed pulmonary metastases. In the literature, CT scans of the thorax and abdominopelvic performed in search of metastatic dissemination have not detected any metastases [5] [8] [9]. Non-Hodgkin's lymphoma is rarely found in soft tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Differential diagnosis with other soft tissue tumors, especially sarcoma, is difficult. Definitive diagnosis is based on histological examination of a biopsy of the tumor [5] [8] [9]. In our case, the diagnosis of small cell muscle lymphoma was established after performing an excisional biopsy of the tumor given an inconclusive first biopsy and in the face of a compressive syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, the diagnosis of small cell muscle lymphoma was established after performing an excisional biopsy of the tumor given an inconclusive first biopsy and in the face of a compressive syndrome. In the literature, large cell lymphomas are the most frequent [2] [4] [9]. The treatment of muscular lymphomas, although unequivocal, can only be conceived in a multidisciplinary framework (associating orthopaedist, radiologist, pathologist, oncologist and radiotherapist).…”

Section: Discussionmentioning

confidence: 99%

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Small Cell Lymphoma of the Gastrocnemius Muscle: A Case Report

Moussa¹,

Toure²,

Coulibaly³

et al. 2023

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Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in Mali and to do a review of the literature. Clinical Observation: It was about a 34-year-old woman who consulted 3 months after the onset of symptoms for swelling and pain in the left calf. On clinical examination there was a hard, painful and warm mass in the left calf, with paresthesias in the tibial nerve territory associated with partial functional impotence of the leg. The ultrasound revealed a hyper echogenic and heterogeneous non-vascularized mass of the left gastrocnemius muscle measuring 65 × 45 × 40 mm non-vascularized on color Doppler and pulsed in favor of myositis. Magnetic resonance imaging (MRI) concluded in a well-limited heterogeneous cystic mass in the left gastrocnemius muscle respecting the bone of benign appearance: remodeled Baker's cyst? Considering the radioclinical unconformity, thoraco-abdominal CT was performed and revealed pulmonary metastasis. The biopsy carried out concluded with a small cell lymphoma of the gastrocnemial muscle. Marginal resection was performed associated with adjuvant chemotherapy. The advancement at 9 months was satisfactory.

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Intramuscular lymphoma: uncommon presentation of Hodgkin’s disease

et al. 2020

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Extranodal presentation in lymphoproliferative disorders is a well-recognised entity. However, musculoskeletal involvement is extremely rare. We describe the case of a 64-year-old farmer who presented to us with constitutional symptoms of fever, loss of weight and loss of appetite for 2 years and physical examination revealing generalised lymphadenopathy with hepatosplenomegaly. Biopsy of an axillary lymph node showed mixed cellularity variant of Hodgkin’s lymphoma. CT of the thorax and abdomen revealed a collection in the right psoas muscle. Guided biopsy of the psoas deposit was suggestive of Hodgkin’s lymphoma. PCR and cultures for Mycobacterium tuberculosis tested negative. Here we describe a rare presentation of Hodgkin’s lymphoma with intramuscular involvement.

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Lymphome non Hodgkinien intramusculaire primitif chez le sujet jeune: à propos d’un cas et revue de la littérature

Cited by 4 publications

References 11 publications

A Rare Case of Aggressive Non-Hodgkin's Lymphoma of the Muscle in a Young Male Presenting as Necrotizing Myofasciitis

A Rare Case of Aggressive Non-Hodgkin's Lymphoma of the Muscle in a Young Male Presenting as Necrotizing Myofasciitis

Small Cell Lymphoma of the Gastrocnemius Muscle: A Case Report

Intramuscular lymphoma: uncommon presentation of Hodgkin’s disease

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