[P-25] Extra-nodal diffuse large B cell lymphoma (non-germinal centre type) of manus: a case report
Fitria Sholihah1,2, Harry Galuh N2,3 and Bethy S Hernowo1,2
- Anatomical Pathology Department, Hasan Sadikin General Hospital, Bandung, Indonesia
- Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Radiology Department, Hasan Sadikin General Hospital, Bandung, Indonesia
Background: Lymphoma of soft tissues are rare. They had been reported to occur 1.4% of all lymphoma cases.
Case Presentation: A 67-year-old male presented with painful rapidly growing soft tissue mass and ulcer in left manus, 6 months prior to hospitalisation. Radiologic imaging of left manus showed soft tissue mass damaging metacarpal, pisiform, triquetrum and hamatum bones. Lymphadenopathy of neck and axilla was found several weeks after amputation. Histopathological examination from left manus revealed small round blue cell tumour infiltrating cutaneous, subcutaneous and bone tissues. Immunohistochemistry revealed negative for BCl6, CD5, CD10, CD23, CD99, CK, myoD1, myogenin and osteocalcin. The tumour had positive immunoexpression of CD3, CD20, CD45 and MUM1. Ki-67 yielded strong immunoreactivity in more than 40% of tumour cells. The final histopathological diagnosis was extra-nodal diffuse large B cell lymphoma, non-germinal centre type of manus. The patient underwent six cycles of chemotherapy with RCHOP.
Discussion and Conclusion: Lymphoma of soft tissue usually manifests as swollen painful mass. The main site involved are thigh, trunk and lower limbs. The mechanism of lymphomatous involvement in soft tissue can be direct invasion from adjacent lymph nodes, metastatic spread and primary even though very rare. The most common histologic subtype is diffuse large B cell lymphoma (DLBCL). Because of its rarity, it is important to differentiated soft tissue lymphoma from other sarcomas. The treatment of soft tissue lymphomas relies on the type of lymphoma. The prognosis is generally poor.
