Knowles Brett, Serpell Jonathan W
Department of Surgery, Alfred Hospital, Monash University, Victoria, Australia.
ANZ J Surg. 2003 Jan-Feb;73(1-2):26-30. doi: 10.1046/j.1445-2197.2003.02613.x.
A variety of soft-tissue tumours result in soft-tissue masses, which are all differential diagnoses of soft-tissue sarcomas. A rare cause is extra-nodal lymphoma which, unlike a soft-tissue sarcoma which it mimics, should not be excised, but rather treated by chemotherapy and/or radiotherapy. The aim of the present study was to identify clinical, radiological, biopsy and management features of lymphoma when presenting as a soft-tissue mass.
A review of 17 cases of soft-tissue lymphoma presenting as a soft-tissue mass from a total database of 295 soft-tissue tumours was undertaken. Lymphomas arising in cervical, axillary and inguinal nodes were excluded.
All patients presented with a soft-tissue mass but none had the symptoms of lymphoma. Computed tomography scanning identified seven (54%) of 13 with regional lymphadenopathy, six (46%) of 13 with encasement of major vascular structures and three with invasion across major soft-tissue boundaries. Core biopsy established a diagnosis in 13 patients (sensitivity 93%). All patients were treated with either chemotherapy and/or radiotherapy and all are alive with a mean follow up of 19 months. None underwent major resectional surgery.
The present series highlights a rare subgroup of patients with extra-nodal soft-tissue lymphoma mimicking soft-tissue sarcoma. Core biopsy is accurate in their diagnosis. Computed tomography scanning may show features suggesting the diagnosis.
多种软组织肿瘤可导致软组织肿块，这些都是软组织肉瘤的鉴别诊断。一种罕见的病因是结外淋巴瘤，与它所模仿的软组织肉瘤不同，结外淋巴瘤不应进行切除，而应采用化疗和/或放疗进行治疗。本研究的目的是确定表现为软组织肿块的淋巴瘤的临床、放射学、活检及治疗特征。
从295例软组织肿瘤的总数据库中回顾了17例表现为软组织肿块的软组织淋巴瘤病例。排除起源于颈部、腋窝和腹股沟淋巴结的淋巴瘤。
所有患者均表现为软组织肿块，但均无淋巴瘤症状。计算机断层扫描显示，13例中有7例（54%）出现区域淋巴结肿大，13例中有6例（46%）出现主要血管结构包绕，3例出现跨越主要软组织边界的侵犯。13例患者通过粗针活检确诊（敏感性93%）。所有患者均接受了化疗和/或放疗，平均随访19个月后全部存活。无一例接受大的切除手术。
本系列研究突出了一组罕见的模仿软组织肉瘤的结外软组织淋巴瘤患者亚组。粗针活检对其诊断准确。计算机断层扫描可能显示提示诊断的特征。
