Total Knee Arthroplasty Complicated by Diffuse Large B-Cell Lymphoma

Area of Science:

• Oncology
• Orthopedic Surgery
• Dermatology

Background:

• A 74-year-old male with a history of total knee arthroplasty presented with symptoms of knee revision surgery.
• The patient exhibited unusual cutaneous nodules around the anterior knee, raising suspicion for infection.

Purpose of the Study:

• To report a rare case of cutaneous diffuse large B-cell lymphoma presenting as skin nodules around a total knee arthroplasty.
• To emphasize the importance of accurate diagnosis and management of atypical skin lesions in patients with prior orthopedic surgery.

Main Methods:

• Clinical presentation of a patient with a prior total knee arthroplasty.
• Diagnostic workup including biopsy of cutaneous nodules.
• Multimodal treatment involving chemotherapy, radiation, and subsequent revision surgery.

Main Results:

• Biopsy confirmed cutaneous diffuse large B-cell lymphoma, not infection.
• Chemotherapy and radiation led to complete resolution of the lymphoma.
• The patient subsequently underwent a successful aseptic revision total knee arthroplasty.

Conclusions:

• Atypical cutaneous lesions around surgical sites require thorough investigation beyond common complications.
• Early and accurate diagnosis of rare conditions like cutaneous lymphoma is crucial.
• Multidisciplinary management can lead to favorable outcomes in complex orthopedic cases.