Akuzawa Nobuhiro, Hatori Takashi, Takase Aya, Aoki Jun, Sakurai Shinji, Kurabayashi Masahiko
Department of General Medicine, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma 377-0280, Japan.
Department of Internal Medicine, Japan Community Health Care Organization Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
Case Rep Hematol. 2017;2017:3902748. doi: 10.1155/2017/3902748. Epub 2017 Feb 20.
An 84-year-old Japanese man taking warfarin to prevent cerebral infarction secondary to atrial fibrillation was admitted to our hospital for evaluation of a painless right back mass. Magnetic resonance imaging (MRI) showed an oval-shaped mass in the right psoas major muscle. The mass showed high intensity on T1-, T2-, and diffusion-weighted imaging and mimicked an acute-phase hematoma. However, it showed no chronological changes typical of a hematoma, and MRI revealed enlargement of the mass 1 week after admission. Histopathological examination of a biopsy specimen revealed diffuse large B-cell lymphoma (DLBCL). Although skeletal muscle lymphoma is rare, physicians should be familiar with its MRI characteristics. In addition, determination of the lymphoma subtype has important implications for the treatment of skeletal muscle lymphoma because DLCBL may have an especially poor prognosis.
一名84岁的日本男性因心房颤动继发脑梗死而服用华法林，因无痛性右背部肿块入院接受评估。磁共振成像（MRI）显示右腰大肌有一个椭圆形肿块。该肿块在T1加权成像、T2加权成像和弥散加权成像上均表现为高信号，类似急性期血肿。然而，它并未表现出典型血肿的时间变化，且MRI显示入院1周后肿块增大。活检标本的组织病理学检查显示为弥漫性大B细胞淋巴瘤（DLBCL）。尽管骨骼肌淋巴瘤罕见，但医生应熟悉其MRI特征。此外，确定淋巴瘤亚型对骨骼肌淋巴瘤的治疗具有重要意义，因为DLBCL的预后可能特别差。
