MR imaging findings of extranodal-skeletal muscle lymphoma

Transcription

1 R imaging findings of extranodal-skeletal muscle lymphoma Poster No.: C-0261 Congress: ECR 2013 Type: Scientific Exhibit Authors: C. A. Kadioglu, S. Keskin,. A. Yinanc, O. Ertunç; Ankara/TR Keywords: usculoskeletal system, usculoskeletal soft tissue, R, Diagnostic procedure, Contrast agent-intravenous, Imaging sequences, DOI: /ecr2013/C-0261 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 11

2 Purpose We have tried to assign the R Imaging features of primary or nonprimary skeletal muscle lymphoma masses. Page 2 of 11

3 ethods and aterials R Images of pathologically proven skeletal muscle Non-Hodgkin lymphoma in 12 patients were re-analyzed retrospectively. Four of 12 patients had primary skeletal muscle lymphoma. By the way, we tried to determine that if there are individual, specific signal-intensity and enhancement features of extranodal lymphoma masses on RI or not. R Imaging was performed with "1.5T GE edical Systems, Signa Excite-3, Waukesha, WI, USA" by using 3-5 mm slice thickness. We have assessed the enhancement type and signal intensity feature of each lesion on T1-Weighted, T2-Weighted and T2-Weighted Fast Spin-Echo (FSE) sequences. Page 3 of 11

4 Results The clinical presentation of skeletal muscle lymphoma was a mass lesion in all 12 of our cases and additionally muscle enment was the crucial finding. We reviewed the intensity pattern and found out that all of the lesions were isointense or slightly hyperintense on T1-W sequences, compared to normal muscle tissue. On the other hand, on T2-W images all of the masses had exposed intermediate signal, compared to normal adipose tissue. Ten of the patients were evaluated by the contrast-enhancement patterns. Skeletal muscle lymphoma masses exhibited diffuse homogenous enhancement in 8 patients that means %80 of the cases. We described peripheral-band type enhancement only in 2 patients (%20). Patient Age Gender Lesion T1W T2W LocationType (To (To Normal Normal uscle) Fat) T2W FSE Enhancement Histopathology Type (To Normal Fat) 1 76 ShoulderPrimary Signal Diffuse 2 64 Shoulder Diffuse Diffuse Signal 3 46 Thigh Diffuse Diffuse 4 70 Arm Diffuse Diffuse Signal 5 35 Thigh Primary Diffuse Diffuse Page 4 of 11

5 6 71 Leg Signal PeripheralPeripheral Band T-cell 7 79 F Arm Diffuse Peripheral T-cell 8 56 F Thigh 9 83 Thigh Primary PeripheralPeripheral Signal Band T-cell Leg F Back Diffuse Anaplastic Large cell Trunk Primary Signal Diffuse Diffuse Diffuse Diffuse Burkitt Page 5 of 11

6 Images for this section: Fig. 1: uscle enlarging lesion is isointense on T1-W sequences, compared to normal muscle tissue. On T2-W and T2-W FSE images, mass exposes intermediate signal, compared to normal adipose tissue. Bone destruction and adjacent deep soft tissue invasion can also be assigned. Radiology, Ufuk University Hospital - Ankara/TR Page 6 of 11

7 Fig. 2: uscle enlarging lesion is isointense on T1-W sequences, compared to normal muscle tissue. On T2-W and T2-W FSE images, mass exposes intermediate signal, compared to normal adipose tissue. Bone destruction and adjacent deep soft tissue invasion can also be assigned. Radiology, Ufuk University Hospital - Ankara/TR Page 7 of 11

8 Fig. 3: uscle enlarging lesion is isointense on T1-W sequences, compared to normal muscle tissue. On T2-W and T2-W FSE images, mass exposes intermediate signal, compared to normal adipose tissue. Bone destruction and adjacent deep soft tissue invasion can also be assigned. Radiology, Ufuk University Hospital - Ankara/TR Page 8 of 11

9 Fig. 4: uscle enlarging lesion is isointense on T1-W sequences, compared to normal muscle tissue. On T2-W and T2-W FSE images, mass exposes intermediate signal, compared to normal adipose tissue. Bone destruction and adjacent deep soft tissue invasion can also be assigned. Radiology, Ufuk University Hospital - Ankara/TR Page 9 of 11

10 Conclusion Primary or nonprimary skeletal muscle lymphoma is really rare entity that R Imaging findings are relatively specific to distinct these lesions from other malignant soft tissue masses, like sarcomas. As the radiologists, we must make an accurate differential diagnosis for the accurate treatment option; lesion intensity and enhancement pattern can guide us. Page 10 of 11

11 References Komatsuda, Nagao T, Arimori S. An autopsy case of malignant lymphoma associated with remarkable infiltration in skeletal muscles [in Japanese]. Rinsho Ketsueki 1981;22: Lee VS, artinez S, Coleman RE. Primary muscle lymphoma: clinical and imaging findings. Radiology 1997;203: Travis WD, Banks P, Reiman H. Primary extranodal soft tissue lymphoma of the extremities. Am J Surg Pathol 1987;11: O'Neill JK, Devaraj V, Silver DA, Sarsfield P, Stone CA. Extranodal lymphomas presenting as soft tissue sarcomas to a sarcoma service over a two-year period. J Plast Reconstr Aesthet Surg 2007;60: Beggs I, Primary muscle lymphoma. Clin Radiol 1997;52: Hwang S. Imaging of lymphoma of the musculoskeletal system. Radiol Clin North Am 2008;46: Seok JH, Jee WH, Chun KA, et al. Necrotizing fasciitis versus pyomyositis: discrimination with using RI. Korean J Radiol 2009;10: Page 11 of 11