Skip to main content
Log in

Lymphoma presenting as a musculoskeletal soft tissue mass: MRI findings in 24 cases

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose was to describe the MRI morphological features and signal intensity (SI) characteristics of 24 histologically proven cases of musculoskeletal soft tissue lymphoma presenting clinically as a suspected primary soft tissue sarcoma. This was a retrospective review of clinical notes and MRI studies of 24 patients with a histologically confirmed diagnosis of lymphoma. All patients presented to a specialist orthopaedic oncology unit with a suspected primary soft tissue sarcoma. Features assessed included lesion size and morphology, location, extension across anatomical compartments and signal intensity characteristics. The lesions were predominantly poorly defined with peritumoral oedema in ten cases. All tumours were of intermediate T1W SI, while 85% of lesions also showed intermediate T2W SI. Almost all cases that were located just deep to the fascia showed subcutaneous extension, while 50% had involvement of more than one muscle compartment. In 29% of cases, there was extension of tumour along the neurovascular bundle. Histo-pathologically, 23 lesions were non-Hodgkin’s B-cell lymphoma. The MRI features of primary musculoskeletal soft tissue lymphoma include a mass with intermediate SI on T1W and T2W images, involvement of more than one anatomical compartment, subcutaneous extension and extension along the neurovascular bundle.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Freeman C, Berg JW, Cutler SJ (1972) Occurrence and prognosis of extranodal lymphomas. Cancer 29:252–260

    Article  PubMed  CAS  Google Scholar 

  2. Travis WD, Banks PM, Reiman HM (1987) Primary extranodal soft tissue lymphoma of the extremities. Am J Surg Pathol 11:359–366

    Article  PubMed  CAS  Google Scholar 

  3. Komatsuda M, Nagao T, Arimori S (1981) An autopsy case of malignant lymphoma associated with remarkable infiltration in skeletal muscle. Rinsho Ketsueki 22:891–895

    PubMed  CAS  Google Scholar 

  4. Reddy S, Saxena VS, Pellettiere EV, Hendrickson FR (1977) Early nodal and extra-nodal non-Hodgkin’s lymphomas. Cancer 40:98–104

    Article  PubMed  CAS  Google Scholar 

  5. Kransdorf MJ (1995) Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol 164:129–134

    PubMed  CAS  Google Scholar 

  6. Scally J, Garrett A (1989) Primary extranodal lymphoma in muscle. Br J Radiol 62:81

    Article  PubMed  CAS  Google Scholar 

  7. Nelson MC, Petrik JH, Lack EE, Glass-Royal M, Bogumill GP, Stull MA (1990) Lymphocyte-predominant Hodgkin disease manifested as a subcutaneous arm mass. AJR Am J Roentgenol 155:658–659

    PubMed  CAS  Google Scholar 

  8. Grunshaw ND, Chalmers AG (1992) Skeletal muscle lymphoma. Clin Radiol 45:399–400

    Article  PubMed  CAS  Google Scholar 

  9. Metzler JP, Fleckenstein JL, Vuitch F, Frenkel EP (1992) Skeletal muscle lymphoma: MRI evaluation. Magn Reson Imaging 10:491–494

    Article  PubMed  CAS  Google Scholar 

  10. Malloy PC, Fishman EK, Magid D (1992) Lymphoma of bone, muscle, and skin: CT findings. AJR Am J Roentgenol 159:805–809

    PubMed  CAS  Google Scholar 

  11. Panicek DM, Lautin JL, Schwartz LH, Castellino RA (1997) Non-Hodgkin lymphoma in skeletal muscle manifesting as homogeneous masses with CT attenuation similar to muscle. Skeletal Radiol 26:633–635

    Article  PubMed  CAS  Google Scholar 

  12. Eustace S, Winalski CS, McGowen A, Lan H, Dorfman D (1996) Skeletal muscle lymphoma: observations at MR imaging. Skeletal Radiol 25:425–430

    Article  PubMed  CAS  Google Scholar 

  13. Hosono M, Kobayashi H, Kotoura Y, Tsuboyama T, Tsutsui K, Konishi J (1995) Involvement of muscle by malignant lymphoma: MR and CT appearances. J Comput Assist Tomogr 19:455–459

    Article  PubMed  CAS  Google Scholar 

  14. Beggs I (1997) Primary muscle lymphoma. Clin Radiol 52:203–212

    Article  PubMed  CAS  Google Scholar 

  15. Lee VS, Martinez S, Coleman RE (1997) Primary muscle lymphoma: clinical and imaging findings. Radiology 203:237–244

    PubMed  CAS  Google Scholar 

  16. Stiglbauer R, Graninger W, Prayer L, Kramer J, Schurawitzki H, Machold K, Imhof H (1993) Polymyositis: MRI-appearance at 1.5 T and correlation to clinical findings. Clin Radiol 48:244–248

    Article  PubMed  CAS  Google Scholar 

  17. Gordon BA, Martinez S, Collins AJ (1995) Pyomyositis: characteristics at CT and MR imaging. Radiology 197:279–286

    PubMed  CAS  Google Scholar 

  18. Adams EM, Chow CK, Premkumar A, Plotz PH (1995) The idiopathic inflammatory myopathies: spectrum of MR imaging findings. Radiographics 15:563–574

    PubMed  CAS  Google Scholar 

  19. Fleckenstein JL, Burns DK, Murphy FK, Jayson HT, Bonte FJ (1991) Differential diagnosis of bacterial myositis in AIDS: evaluation with MR imaging. Radiology 179:653–658

    PubMed  CAS  Google Scholar 

  20. Hanna SL, Kaste S, Jenkins JJ, Hewan-Lowe K, Spence JV, Gupta M, Monson D, Fletcher BD (2002) Epithelioid sarcoma: clinical, MR imaging and pathologic findings. Skeletal Radiol 31:400–412

    Article  PubMed  CAS  Google Scholar 

  21. Berg AR, Linder J, Anderson RW, Tempero MA, Edney JA, Armitage JO (1985) The undifferentiated malignant neoplasm. Identification of lymphoma arising in skeletal muscle by immunohistochemical analysis. JAMA 254:2625–2626

    Article  PubMed  CAS  Google Scholar 

  22. Agur AMR (1991) Grant’s Atlas of Anatomy. 9th edn. Williams & Wilkins, Baltimore, Philadelphia, Hongkong

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. O’Donnell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suresh, S., Saifuddin, A. & O’Donnell, P. Lymphoma presenting as a musculoskeletal soft tissue mass: MRI findings in 24 cases. Eur Radiol 18, 2628–2634 (2008). https://doi.org/10.1007/s00330-008-1014-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-008-1014-x

Keywords

Navigation