A An Unusual Presentation of Primary Extra Nodal Non-Hodgkin Lymphoma
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Abstract
Patients presented with soft tissue lesions without any β symptoms can be a case of Primary extranodal Non- non-Hodgkins lymphoma. According to the World Health Organization classification system, there are two types of Lymphoma with various sub-types of Hodgkins Lymphoma and Non-Hodgkin Lymphoma are classified to assess the disease burden Progression and metastasis Imaging modalities are helpful. Commonest site involvement in Non-Hodgkin Lymphoma in the gastrointestinal tract (44%) followed by Head and Neck and may Involve bone (8%) and Central Nervous System 5%. Diffuse large β-Cell Lymphoma is the most common subtype representing 30%-35% of all Non-Hodgkin Lymphoma Cases. Oral and Para oral sites were involved in 2.5% of the cases. A 27-year-old Male noticed a swelling in the flank which was progressively Increasing in size one year back later it was associated with pain which reduced mobility and pain was increased during walking. Due to the advancement of diagnostic techniques, it is easy to get the radiological picture and correlation with clinical presentation and pathological reports, but these facilities are not available at various centers. Usually, patients are present in very advanced stages because of a lack of awareness about the disease, and how to proceed for diagnosis and treatment resulting in poor outcomes for these patients. This presentation and clinical funding are rare in the case of Lymphoma. This case report allows us to think of another diagnosis rather than usual.
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References
2) Moussaly E, Nazha B, Zaarour M, Atallah JP. Primary non-Hodgkin’s lymphoma of the spine: a case report and literature review. World J Oncol. 2015;6(5):459-463. doi: 10.14740/wjon947w.
3) Popescu M, Popov V, Popescu G, Dobrea C, Sandu A, Grigorean VT, Strambu V. Spinal involvement with spinal cord compression syndrome in hematological diseases. Rom J Morphol Embryol. 2012;53(4):1069-72.
4) Essadi l, Ismaili N, Tazi E, Elmajjaoul S, Saidi A, Ichou M, Errihani H. Primary lymphoma of the head and neck: two case reports and review of the literature Cases J. 2008;1(1):426. doi: 10.1186/1757-1626-1-426.
5) Chiu BC, Weisenburger DD. An update of the epidemiology of non- Hodgkin’s lymphoma Clin Lymphoma. 2003;4(3):161-8. doi: 10.3816/clm.2003.n.025.
6) DeVita VT, Hellman S, Rosenberg SA. Cancer: Principles and practice of Oncology. Wolters Kluwer; 2001;11:1671-1707
7) Nasirmohtaram S, Mesbah A, Mazloom F. An extremely rare presentation of non-Hodgkin lymphoma in the head and neck: a case report. Egypt J Otolaryngol 2022;38:110. doi: 10.1186/s43163-022-00281-3
8) El Asri AC, Akhaddar A, Baallal H, Boulahroud O, Mandour C, Chahdi H, Mikdame M, Gazzaz M, El Mostarchid B, Boucetta M. Primary lymphoma of cranial vault: case report and a systematic review of the literature. Acta Neurochir (Wien). 2012;154(2):257-265. doi: 10.1007/s00701-011-1124-0.
9) Ciftdemir M, Kaya M, Selcuk E, Yalniz E. Tumors of the spine. World J Orthop. 2016;7(2):109-16. doi: 10.5312/wjo.v7.i2.109.
10) Hashi S, Goodwin CR, Ahmed AK, Sciubba DM. Management of extranodal lymphoma of the spine: a study of 30 patients. CNS Oncol. 2018 ;7(2):CNS11. doi: 10.2217/cns-2017-0033.
11) Setta K, Beppu T, Sato Y, Saura H, Nomura J, Sugai T, Ogasawara K. Primary cranial vault lymphoma extending between subcutaneous tissue and brain parenchyma without skull destruction after mild head trauma: a case report and literature review. Case Rep Oncol. 2021;14(2):1118-1123. doi: 10.1159/000516272.
12) Hatem J, Bogusz AM. An unusual case of extranodal diffuse large B-cell lymphoma infiltrating skeletal muscle: a case report and review of the literature. Case Rep Pathol 2016 ;2016:9104839. doi: 10.1155/2016/9104839.
13) Storck K, Brandstetter M, Keller U, Knopf A. Clinical presentation and characteristics of lymphoma in the head and neck region. Head Face Med. 2019;15(1):1. doi: 10.1186/s13005-018-0186-0
14) Scally J, Garrett A. Primary extranodal lymphoma in muscle. Br J Radiol. 1989;62(733):81. doi: 10.1259/0007-1285-62-733-81.
15) Utkan G, Buyukcelik A, Yalcin B, Tek I, Doruk H, Dincol D, Erekul S, Baykara M. Extranodal Hodgkin disease presenting with gluteal mass and hypercalcemia. South Med J. 2006;99(10):1149-50. doi: 10.1097/01.smj.0000240720.24001.77.
16) Katsura M, Nishina H, Shigemori Y, Nakanishi T. Extranodal lymphoma originating in the gluteal muscle with adjacent bone involvement and mimicking a soft tissue sarcoma. Int J Surg Case Rep. 2015;7C:161-4. doi: 10.1016/j.ijscr.2015.01.024.
17) Faraji-Goodarzi M. Sepsis after non-perforated acute appendicitis. Clin Case Rep. 2019;7(3):520-523. doi: 10.1002/ccr3.2030.
18) Masaoka S, Fu T. Malignant lymphoma in skeletal muscle with rhabdomyolysis: a report of two cases. J Orthop Sci. 2002;7(6):688-93. doi: 10.1007/s007760200122
19) Laffosse JM, Gomez-Brouchet A, Molinier F, Chiron P, Roché H, Puget J. A case of malignant primary non-Hodgkin's lymphoma in skeletal muscle treated by exclusive chemotherapy. Joint Bone Spine. 2009;76(1):86-8. doi: 10.1016/j.jbspin.2008.02.022.
20) Yamada S, Shikata A, Yamazaki M, Makoto O, Kikuo M, Yoichi W, Akio K. Primary non-Hodgkin’s lymphoma in the dorsolumbar muscles. Int J Clin Oncol. 1999;4(1):45-47.doi:10.1007/s101470050023
21) Khiewvan B, Macapinlac HA, Lev D, McCutcheon IE, Slopis JM, Al Sannaa G, Wei W, Chuang HH. The value of ¹⁸F-FDG PET/CT in the management of malignant peripheral nerve sheath tumors. Eur J Nucl Med Mol Imaging. 2014;41(9):1756-66. doi: 10.1007/s00259-014-2756-0.
22) Schaefer NG, Hany TF, Taverna C, Seifert B, Stumpe KD, von Schulthess GK, Goerres GW. Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging--do we need contrast-enhanced CT? Radiology. 2004;232(3):823-9. doi: 10.1148/radiol.2323030985.
23) Wang X. PET/CT: appropriate application in lymphoma. Chin Clin Oncol. 2015;4(1):4. doi: 10.3978/j.issn.2304-3865.2014.11.05.
24) Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, LaRocca R, Grant B, DeAngelis LM, Abrey LE. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2007;25(30):4730-5. doi: 10.1200/JCO.2007.12.5062.
25) Carruthers MN, Topazian MD, Khosroshahi A, Witzig TE, Wallace ZS, Hart PA, Deshpande V, Smyrk TC, Chari S, Stone JH. Rituximab for IgG4-related disease: a prospective, open-label trial. Ann Rheum Dis. 2015;74(6):1171-1177. doi: 10.1136/annrheumdis-2014-206605.
26) Wight JC, Yue M, Keane C, Johnston A, Linton K, Chin C, Wai SH, Talaulikar D, Gasiorowski R, Cheah CY, Gregory GP, Dickinson M, Minson A, Coombes C, Ku M, Lam S, Hawkes EA. Outcomes of synchronous systemic and central nervous system (CNS) involvement of diffuse large B-cell lymphoma are dictated by the CNS disease: a collaborative study of the Australasian Lymphoma Alliance. Br J Haematol. 2019;187(2):174-184. doi: 10.1111/bjh.16064.
27) Wang L, Qin W, Huo YJ, Li X, Shi Q, Rasko JEJ, Janin A, Zhao WL. Advances in targeted therapy for malignant lymphoma. Signal Transduct Target Ther. 2020;5(1):15. doi: 10.1038/s41392-020-0113-2.