Intramuscular manifestation of non-Hodgkin lymphoma and myeloma: prevalence, clinical signs, and computed tomography features.
BACKGROUND
Intramuscular manifestations of malignant immunoproliferative diseases (IMMID) are very rare.


OBJECTIVE
To determine the prevalence and the clinical features of IMMID in a large series of patients, and to analyze their radiological appearances.


METHODS
Between 1997 and 2007, 20 patients with IMMID (non-Hodgkin lymphoma [NHL], n=14, and myeloma, n=6) were identified. All patients underwent computed tomography (CT). In five cases, magnetic resonance imaging (MRI) was additionally performed.


RESULTS
Clinically, 16 patients presented with local pain and soft-tissue swelling. In four patients, IMMID was found incidentally. The most common site was the erector spinae muscle, followed by the iliopsoas and pelvic muscles. In 13 cases of IMMID, diffuse mass-forming muscle infiltration was found. Focal intramuscular masses were identified in seven cases.


CONCLUSIONS
NHL mostly manifests as diffuse muscle enlargement, whereas myelomas form focal intramuscular masses. Nevertheless, CT and MR appearances are nonspecific and can be misinterpreted as muscle sarcoma or inflammatory disease. Although rare, muscle involvement should be considered in the differential diagnosis of muscle disorders in patients with non-Hodgkin lymphoma and myeloma.
Surov
Alexey
A
Department of Radiology, Martin Luther University, Halle-Wittenberg, Germany. alex.surow@medizin.uni-halle.de
Holzhausen
Hans-Jürgen
HJ
Arnold
Dirk
D
Schmidt
Jörg
J
Spielmann
Rolf-Peter
RP
Behrmann
Curd
C
D000368:Aged; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000473:pathology; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D019786:Gadolinium DTPA