Primary giant lymphoma of the right thigh: A case report and brief review of the literature

Abstract

Primary soft tissue non-Hodgkin lymphoma (NHL) of the extremities is very rare. The clinical features of NHL mimic those of other soft tissue tumors, particularly sarcoma; however, they should be differentiated, as the treatment and prognosis are completely different. In this study, the case of a 68-year-old female with a giant mass, movement disorder, numbness and painful sensations in the right thigh is presented. Magnetic resonance (MR) imaging revealed a huge circle-shaped mass. Fine needle aspiration cytology (FNAC) of the tumor demonstrated neoplastic small, round cells. The tentative diagnosis was of a mesenchymal sarcoma. The right thigh was amputated. On histological examination of the amputated extremity, the diagnosis was found to be large B cell lymphoma. Primary soft tissue NHL of the extremities is a systemic malignant disease and is sensitive to chemo-therapy and radiotherapy. The histological diagnosis should be identified as far as possible before the tumor is widely excised.

Figure 1

Magnetic resonance imaging of the right thigh. T1WI-MRI coronal image showing an approximately circle-shaped mass measuring 21×12×9.5 cm in size at the posterior aspect of the right thigh. The lesion showed lower signal intensity.

Figure 2

Magnetic resonance imaging of the right thigh. The T2WI-MRI axial image shows uneven high signal intensity of the neoplasm. The border is clearly defined. The muscles and blood vessels in the peripheral region of the lesion were compressed. The sclerotin of the adjacent bone appeared normal in all planes of the images.

Figure 3

Computerized tomography scan showed a soft tissue mass with the diameter of 10 cm in the right gluteus area with irregular contours and right pelvic involvement.