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Subcutaneous mass concerning for sarcoma: a peculiar presentation of diffuse large B-cell lymphoma
  1. John Mayo,
  2. Kenneth Bogenberger,
  3. Thomas Raj and
  4. Jeffrey Reha
  1. General Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
  1. Correspondence to Dr John Mayo, john.s.mayo{at}


Diffuse large B-cell lymphoma (DLBCL) can present in a number of different ways, including as a primary cutaneous lesion or at various other extranodal sites. However, it is rare for a DLBCL to present as a clinically subcutaneous mass without visible skin changes or nodal involvement. A 36-year-old man presented with a 4×4×1 cm subcutaneous mass to his shoulder with normal overlying skin which had been enlarging over 6 months. Physical exam and imaging together made a strong case for sarcoma, and the patient underwent a radical resection. The final pathological diagnosis returned as a diffuse B-cell lymphoma (germinal centre type). The patient subsequently healed and tolerated chemotherapy well. DLBCL can masquerade as a soft tissue mass at initial presentation. If the diagnosis is not clear, a biopsy should be pursued.

  • surgical oncology
  • oncology
  • cancer intervention
  • surgical diagnostic tests

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  • Contributors JM and KB are general surgery residents who wrote the main manuscript together. TR is a staff pathologist who prepared the pathology images, captions and portion of the manuscript. JR is a surgical oncologist staff and the senior author who oversaw every step of the case report process and provided final editing and guidance.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the US Government.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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