Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Republic of Korea.
Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, 816-15 Jinju-daero, Jinju 52727, Republic of Korea.
Curr Med Imaging. 2023;19(7):788-794. doi: 10.2174/1573405618666220831162014.
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non- Hodgkin's lymphoma (NHL). However, the primary skeletal muscle involvement of DLBCL is extremely rare, comprising less than 1% of all the extranodal lymphoma. To date, only 8 cases of extranodal NHL involving the masticator muscles have been reported in the literature.
A 70-year-old male presented with a rapid progression of painless facial swelling in the left cheek. CT, MRI and US findings demonstrated a well-defined, soft tissue mass in the left masseter muscle. The histopathological diagnosis was DLBCL by US-guided core needle biopsy. The patient received three cycles of chemotherapy.
Because of its rarity, primary muscular DLBCL must be considered in differential diagnosis with all possible causes of intramuscular masses. Even the integration of multiple imaging methods does not lead to a definitive diagnosis, the biopsy is the only possibility for an early diagnosis. Therefore, clinical awareness and high suspicion of this disease are important for early diagnosis and proper treatment.
弥漫性大 B 细胞淋巴瘤（DLBCL）是最常见的非霍奇金淋巴瘤（NHL）类型。然而，DLBCL 原发性骨骼肌受累极为罕见，占所有结外淋巴瘤的比例不到 1%。迄今为止，文献中仅报道了 8 例咀嚼肌受累的结外 NHL 病例。
一名 70 岁男性因左侧脸颊无痛性面部肿胀迅速进展而就诊。CT、MRI 和 US 检查结果显示左侧咬肌内有界限清楚的软组织肿块。超声引导下的核心针活检的组织病理学诊断为 DLBCL。患者接受了三个周期的化疗。
由于其罕见性，原发性肌肉 DLBCL 必须与所有可能导致肌肉内肿块的原因进行鉴别诊断。即使整合多种成像方法也不能明确诊断，活检是早期诊断的唯一可能。因此，对这种疾病的临床认识和高度怀疑对于早期诊断和适当治疗很重要。
