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Primary soft tissue sarcoma: stage IV extranodal T-cell non-Hodgkin’s lymphoma
  1. Joshua Christy1,
  2. Emad Kandah1,
  3. Kavitha Kesari2 and
  4. Venkatasiva Peram3,4
  1. 1Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
  2. 2McLaren Health Care Corp, Flint, Michigan, USA
  3. 3Department of Hematology and Oncology, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
  4. 4Hematolgy/Oncology, Triumph Cancer Center, Grand Blanc, Michigan, USA
  1. Correspondence to Dr Joshua Christy; joshua.christy{at}mclaren.org

Abstract

Non-Hodgkin’s lymphoma (NHL) presenting as a soft tissue sarcoma is rare, occurring at a rate of 0.11%. Peripheral T-cell lymphomas comprise 4% of all NHLs. We report the case of a 49-year-old Caucasian man who presented with a mass in the medial aspect of the thigh. Ultrasound showed a complex subcutaneous mass. MRI demonstrated a superficial complex skeletal mass affecting the sartorius muscle with other lesions involving the femur and the gluteus maximus. Positron emission tomography-computed tomography (PET-CT) showed diffuse pulmonary metastases with no involvement of nodes, liver, spleen with high suspicion of advanced sarcoma. Core biopsy revealed a T-cell NHL, and staining was positive for anaplastic lymphoma kinase. The patient received six cycles of cyclophosphamide, doxorubicin, vincristine, etoposide and prednisone. Repeat PET-CT showed reduction in the mass, with no fluorodeoxyglucose-avid uptake. Latest MRI showed near-normal intensity. Further PET-CTs determine disease remission or progression.

  • oncology
  • carcinogenesis

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Footnotes

  • Contributors JC and EK conceived the idea of writing the case report. JC and EK did the literature search. All authors discussed the literature findings and contributed to the final manuscript. JC and EK wrote the manuscript with support from KK and VP. KK and VP supervised the project. All authors reviewed, discussed and provided critical feedback to the final manuscript.

  • 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.

  • Competing interests None declared.

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