title: Hematologic malignancies with primary retroperitoneal presentation: clinicopathologic study of 32 cases.
abstract: BACKGROUND
  The retroperitoneum is an uncommon location for primary lymphomatous involvement. Initial presentation of disease in this site (primary retroperitoneal lymphoma) is considered to be rare. Because of the uncommon anatomic location, the diagnosis and subsequent management of these patients tend to be difficult for both pathologists and clinicians.
  
  
  OBJECTIVE
  This report describes our experience during a period of 6 years 4 months with patients with hematologic malignancies primarily presenting in the retroperitoneum.
  
  
  METHODS
  A retrospective search of our medical records generated 32 patients who presented initially with abdominal pain or discomfort as their predominant symptom and who were found by imaging studies to have retroperitoneal mass or masses. All the histopathology slides were reviewed and classified based on the World Health Organization classification.
  
  
  RESULTS
  There were 13 male and 19 female patients. Tumor types included diffuse large B-cell lymphoma (n = 12); grade 1 follicular lymphoma (n = 4); grade 3 follicular lymphoma (n = 1); B chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 2); multiple myeloma (n = 1); mixed-cellularity Hodgkin lymphoma (n = 1); nodular sclerosis Hodgkin lymphoma (n = 1); aggressive B-cell lymphoma (n = 4); low-grade B-cell lymphoma (n = 4); lymphoblastic lymphoma, null cell type (n = 1); and precursor B-lymphoblastic lymphoma/leukemia (n = 1). More than half of the cases (17/32) were diagnosed on needle biopsy with immunophenotyping.
  
  
  CONCLUSIONS
  Although open lymph node biopsy is a preferred method for diagnosis, needle biopsy plays a significant role in this setting, and, coupled with other information such as flow cytometry and immunohistochemistry, it is considered a practical and reliable method.
authors.affiliation: Department of Pathology, Henry Ford Hospital, Detroit, Mich 48202, USA.
authors.forename: LeiLei
authors.initials: L
authors.lastname: Chen
authors.forename: Philip
authors.initials: P
authors.lastname: Kuriakose
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hawley
authors.forename: Nalini
authors.initials: N
authors.lastname: Janakiraman
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008223:Lymphoma / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D012187:Retroperitoneal Space; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor