oft-tissue lymphoma in the ankle

a case report

Abstract

The lymphoid neoplasms are divided into three categories: Hodgkin’s lymphomas, non-Hodgkin’s lymphomas and plasma cell neoplasms. Primary muscle lymphoma is a rare disease that usually affects the lower limbs. The non-Hodgkin’s lymphoma (NHL) large cell type B is especially the most common lymphoma. Clinical examination is nonspecific and the differential diagnosis includes tumors, hematomas or infections. Imaging tests such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are not conclusive, thus the biopsy is necessary for the final diagnosis. This reported case is a 16-year old boy with a history of volume increase in the soft tissue of the left ankle, with pain on efforts. Radiographs were performed, which showed roughly oval image, radio-transparent in the medial aspect of the cortical of the distal third of the left tibia with sclerotic edges, and the presence of expansive lesion of regular and well-defined contours was observed in the left ankle by the RMI. After biopsy performed, anatomopathological examination showed non-Hodgkin’s lymphoma of large cell type B, infiltrating the fibro-fatty tissue. Immunohistochemistry revealed expression for TdT, CD18, PAX5 and CD20, confirming the diagnosis. Afterwards, the patient was referred to the Hematology team, and underwent Hyper-CVAD Chemotherapy regimen.