Summary
Non-Hodgkin's lymphoma usually presents with lymphadenopathy at multiple sites but
can also involve any part of the musculoskeletal system. Occasionally the presentation
is with a soft tissue mass. The presentation of large, superficial lymphomatous masses
is similar both clinically and radiologically to that of soft tissue sarcomas.
The six cases of lymphoma presenting to the Exeter Sarcoma Service as suspected soft
tissue sarcomas, over a two-year period (2002–2004), are presented. We describe the
clinical and imaging characteristics of these tumours and their subsequent management.
Our cases showed variability in presentation. Only one of the six cases presented
with pain and one with tenderness. Four of the cases had no lymphadenopathy and the
other two had lymphadenopathy restricted to one nodal basin. Overlying soft tissue
swelling occurred in four cases and in distal limb swelling beyond the mass in one
case. Radiologically, lymphomas are known to be likely to exhibit confluent lymphadenopathy
that is rare in patients with soft tissue sarcoma. Confluent lymphadenopathy was demonstrated
in only one case of this series of patients. It is thought that lymphomas infiltrate
across anatomical fascial planes more readily than sarcomas and in four of our six
cases this feature was present.
Clinical history, examination and MRI are insufficient to differentiate between soft
tissue sarcoma and lymphoma and the importance of obtaining a pathological diagnosis
prior to surgery is clear. It is crucial to differentiate lymphoma from sarcoma in
order to avoid unnecessary excisional procedures in lymphoma patients.
Keywords
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Article info
Publication history
Published online: June 06, 2006
Accepted:
March 29,
2006
Received:
November 15,
2005
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
