Dai Yue, Sowjanya Medapati, You Jia, Xu Kai
From the Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China (YD, JY); and School of Medical Imaging, Xuzhou Medical College, Xuzhou 221004, China (YD, MS, JY, KX).
Medicine (Baltimore). 2015 May;94(18):e833. doi: 10.1097/MD.0000000000000833.
As normal healthy skeletal muscle does not contain lymphoid tissue, extra nodal lymphoma involving multiple muscles is rare, as well. This study reports a case of non-Hodgkin's lymphoma (NHL) of multiple skeletal muscles involvement and a review of differential diagnosis of it.A 37-year-old female presented to our hospital after being diagnosed with NHL for 7 months. She had received six courses of cyclophosphamide hydroxydaunorubicin oncovin prednisolone etoposide (CHOPE) chemotherapy. Then she felt pain and noticed swelling on her left calf. The fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) image showed abnormal focal FDG uptake in hypo-pharynx, which was the primary NHL and also in multiple groups of muscles in whole body. As the patient has history NHL, lymphoma of multiple muscle involvement was suspected.Finally, an ultrasound-guided tissue biopsy was performed on the left calf and histological examination yielded lymphomatous cells infiltration in the left gastrocnemius.Through this report, we emphasize that a multidisciplinary team approach with clinician, radiologist, and pathologist is essential for proper diagnosis, staging, and management of such rare lesions.
由于正常健康的骨骼肌不含淋巴组织，累及多块肌肉的结外淋巴瘤也很罕见。本研究报告了1例累及多块骨骼肌的非霍奇金淋巴瘤（NHL）病例，并对其鉴别诊断进行综述。一名37岁女性在被诊断为NHL 7个月后就诊于我院。她接受了6个疗程的环磷酰胺、羟基柔红霉素、长春新碱、泼尼松龙、依托泊苷（CHOPE）化疗。之后她感到左小腿疼痛并发现肿胀。氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）图像显示下咽有异常局灶性FDG摄取，这是原发性NHL，全身多组肌肉也有异常摄取。由于该患者有NHL病史，怀疑有多块肌肉受累的淋巴瘤。最后，在左小腿进行了超声引导下组织活检，组织学检查显示左侧腓肠肌有淋巴瘤细胞浸润。通过本报告，我们强调临床医生、放射科医生和病理科医生的多学科团队方法对于此类罕见病变的正确诊断、分期和管理至关重要。
