Lymphoma in soft tissue: a clinicopathologic study of 19 cases

The authors retrospectively reviewed 19 patients who presented with lymphoma as soft tissue masses, without evidence of lymph node or skin involvement. Sites of involvement included lower extremity (seven), upper extremity (six), chest wall (three), gluteal region (two), and frontal subgaleal region (one). Histological and immunophenotypic studies revealed 12 large cell lymphomas (11 B cell and one T cell), two small noncleaved cell lymphomas (B-cell phenotype), and five low grade B-cell lymphomas (two small lymphocytic and three follicular mixed lymphomas). Patients with large cell lymphoma, including seven patients with stages I and II and five patients with stage IV, were treated with anthracycline-based chemotherapy, with or without radiation therapy. One half of these patients are dead of disease, including four of seven with low stage disease. The two patients with small noncleaved cell lymphoma had stage IE disease and were treated with chemotherapy; one died at 11 months, and the other is alive and disease free at 65 months. Patients with low grade B-cell lymphoma included four stage IE patients who were treated with radiation and one stage IV patient treated with chemotherapy. Two patients are alive and disease free, and three are dead of unrelated causes. The authors conclude that malignant lymphomas initially diagnosed in soft tissues are most commonly large cell lymphomas with a B-cell phenotype.