Massive skeletal muscle invasion by lymphoma

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Diffuse large-cell lymphoma (DLCL) is an aggressive non-Hodgkin lymphoma.
• Skeletal muscle involvement by lymphoma is uncommon.
• Understanding rare presentations is crucial for timely diagnosis and treatment.

Observation:

• Three patients presented with diffuse enlargement of thigh skeletal muscles due to DLCL infiltration.
• One case was de novo DLCL; two had histories of nodular lymphoma and Hodgkin's disease.
• Computed tomographic (CT) scanning revealed enhancing thigh masses infiltrating muscle groups and abnormal adjacent long bone medullary cavities.

Findings:

• CT imaging demonstrated characteristic features of muscle infiltration and bone involvement.
• Muscle biopsy confirmed DLCL in two of the three patients.
• The findings highlight the importance of considering lymphoma in cases of unexplained muscle enlargement.

Implications:

• This presentation of DLCL underscores the need for comprehensive diagnostic workup in cases of skeletal muscle masses.
• Radiological findings, particularly CT, can suggest lymphoma infiltration of muscles and bones.
• Early and accurate diagnosis through biopsy is critical for initiating appropriate oncological management and improving patient outcomes.