CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
Primary non-Hodgkin lymphoma in the muscle of left lower extremity: a case report and literature review
Provisionally accepted
- 1Zibo Hospital of traditional Chinese Medicine, shandong, China
- 2Zibo Central Hospital, Shandong, China
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Abstract: Primary non-Hodgkin lymphoma (NHL) of the left lower extremity muscle is a rare exonodal lymphoma, accounting for less than 1% of all exonodal NHL. We report a rare case of intramuscular NHL of the left lower extremity and discuss its clinical features, diagnostic challenges, and treatment strategies with reference to the literature. The patient, an adult male, was treated for sudden swelling and pain in the left lower limb. Ultrasound examination revealed hypoechoic myometrium (hematoma considered), and ultrasound-guided puncture biopsy confirmed "primary CD5 + diffuse large B-cell lymphoma (leg type)"; the patient received 6 chemotherapy, and the symptoms were significantly relieved, but early local recurrence occurred; the clinical manifestations and imaging features of primary NHL in skeletal muscle lacked specificity, and the diagnosis depended on pathology and molecular analysis. Its pathogenesis may be related to direct invasion, hematogenous metastasis or primary muscle lesions. CD5 + diffuse large B-cell lymphoma (DLBCL) is aggressive and R-CHOP combined with radiotherapy is recommended, but prognosis is affected by age, LDH levels, and molecular characteristics such as TP53 mutations. Primary non-Hodgkin lymphoma in the muscle of left lower limb is very rare. It is difficult to diagnose it by imaging examination alone. It needs to be considered comprehensively by combining various examination methods. Pathology is the gold standard for diagnosis. Radiotherapy and chemotherapy are the first choice for treatment. It is very important to formulate reasonable treatment plan according to the results of pathology and molecular analysis.
Keywords: Lower limb muscle, Ultrasound diagnosis, magneticresonanceimagingdiagnosis, Pathologicaldiagnosis, non-Hodgkin lymphoma
Received: 04 Aug 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Du, Zhang, Zhou, Huo, Xu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenzhe Xu, zkyy2009@126.com
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