Non-Hodgkin's Lymphoma: Atypical Presentation as Upper Limb Compartment Syndrome

Non-Hodgkin's lymphoma (NHL) most commonly presents with fever, weight loss, night sweats, and generalised lymphadenopathy. It usually arises from lymphoid tissues and few extranodal sites like the gastrointestinal tract, skin, ovaries, kidneys, testis, adrenal glands, and thyroid. Among the extranodal sites, involvement of skeletal muscles has been found to be highly unusual, accounting for only 0.5% of all cases. Thus, we would like to share the case of a 75-year-old male who presented with diffuse swelling in the left upper limb, persisting for a duration of 7 days with a recent history of blunt trauma. On examination, diffuse swelling, tenderness, and erythema were noted in the left upper limb, extending from the hand till the shoulder with skin changes and blister formation. Both ulnar and radial artery pulsations were feeble. Fasciotomy was done in the left forearm and arm in view of the compartment syndrome, and muscle biopsy of a suspicious unhealthy-looking muscle was sent, which was eventually reported as the B-cell lymphoblastic variety of NHL. In conclusion, this rare case of NHL presenting as upper limb compartment syndrome highlights the importance of considering atypical presentations in lymphoma diagnosis.