Subcutaneous mass concerning for sarcoma: a peculiar presentation of diffuse large B-cell lymphoma

BMJ Case Rep. 2019 Jul 27;12(7):e229327. doi: 10.1136/bcr-2019-229327.

Abstract

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.

Keywords: cancer intervention; oncology; surgical diagnostic tests; surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Gene Expression Profiling
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / surgery
  • Male
  • Margins of Excision
  • Sarcoma / pathology*
  • Shoulder / pathology*
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / surgery
  • Treatment Outcome