Tülay AKMAN, Özden PİŞKİN, Mehmet Ali ÖZCAN, İnci ALACACIOĞLU, Güner Hayri ÖZSAN, Fatih DEMİRKAN, Bülent ÜNDAR, Metin MANİSALI, Sermin ÖZKAL

Primer İskelet Kası Lenfoması Olan İki Olgu Ve Literatür Derlemesi

Primer olarak iskelet kası lenfoması nadirdir. Tüm ekstranodal tutulum gösteren lenfomaların %0,5'inde görülür. En sık görülen alt grubu diffüz büyük hücreli lenfomadır ve B hücreli immünfenotipe sahiptir. Ekstremite kasları; özellikle de alt ekstremite kasları en sık tutulan bölgelerdir. Çoğu hasta 60 yaş üzerindedir. Hastalığın patogenezi tam olarak bilinemese de; etyolojide sorumlu birkaç hipotezde infeksiyöz ve otoimmün sürece sekonder kronik enflamasyon yer almaktadır. Diffüz büyük hücreli histolojiye sahip primer ekstranodal iskelet kası lenfomasının tedavisinin temelini CHOP kemoterapi rejimi ve radyoterapi oluşturmaktadır. Biz makalemizde kafa travması sonrasında ortaya çıkan; temporal kas içine yerleşmiş olan primer kas lenfoması saptadığımız olgumuzu ve yetmiş yedi yaşında sağ bacak arka yüzde popliteal bölgede primer kas lenfoması saptadığımız olgumuzu sunduk.

TWO CASES WITH PRIMARY SKELETAL MUSCLE LYMPHOMA AND REVIEW OF THE LITERATURE

Primary skeletal muscle lymphoma is rare. It consists 0.5% of all extranodal lymphomas. The most common seen subtype is diffuse large cell lymphoma and has B cell immunophenotype. Extremity muscles; especially lower extremity muscles are the most effected sites. Most of the patients are older then 60 years old. Although the pathogenesis is not exactly known; one of the several hypothesis about the etiology is chronic inflamation secondary to infectious and autoimmune process. The basic treatment modalities for primary extranodal lymphoma with diffuse large cell histology are CHOP chemotherapy and radiotherapy. In our article we presented our case with primary muscle lyphoma at the temporal muscle and another case with primary muscle lyphoma at the back of the popliteal region of right limb.

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1. Komatsuda M, Nagao T, Arimori S. An autopsy case of malignant lymphoma associated with remarkable infiltration ın skelatal muscles. Rinsho Ketsueki 1981;22:891- 895.
2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-260.
3. Glass AG, Karnell LH, Menck HR. The National Cancer Data Base report on non-Hodgkin's lymphoma. Cancer 1997;80:2311-2320.
4. Buerger LF, Monteleone PN. Leukemic-lymphomatous infiltration of skeletal muscle. Cancer 1966;19:1416-1422.
5. Chim CS, Choy C, Liang R. Primary anaplastic large cell lymphoma of skeletal muscle presenting with compartment syndrome. Leuk Lymphoma 1999,33:601-605.
6. Keung Y, Liang R. Report of a case of primary skeletal muscle lymphoma and review of the literature. Acta Haematol 1996;96:184-186.
7. Bertoni F, Sanna P, Zucca E, et al. Primary extranodal lymphoma of skeletal muscles: a report of four cases. Oncol Rep 1998;5:605-607.
8. Bertoni F, Sanna P, Zucca E, Roggero E, Cavalli F. Primary extranodal lymphoma of skeletal muscles: a report of four cases. Oncol Rep 1998;5:605-607.
9. Masaoka S, Fu T. Malignant lymphoma in skeletal muscle with rhabdomyolysis: a report of two cases. J Orthop Sci 2002;7:688-693.
10. Zucca E, Roggero E, Bertoni F, et al. Primary extranodal non-Hodgkin's lymphomas. Part 1: gastrointestinal, cutaneous andgenitourinary lymphomas. Ann Oncol 1997;8:727-737.
11. Meister HP. Malignant lymphomas of soft tissues. Verh Dtsch Ges Pathol 1992;76:140-145.
12. Maurer R, Tanner A, Honegger HP, et al. Primary nonHodgkin's lymphoma of the muscles. Schweiz Med Wochenschr 1988;118:354-357.
13. Lum GH, Cosgriff TM, Byrne R, et al. Primary T-cell lymphoma of muscle in a patient infected with human immunodeficiency virus. Am J Med 1993;95:545-546.
14. Iuchi K, Ichimiya A, Akashi A, et al. Non-Hodgkin's lymphoma of the pleural cavity developing from long standing pyothorax. Cancer 1987;60:1771-1775.
15. Holmes GKT, Stokes PL, Sorahan TM, Prior P, Waterhouse JAH, Cooke WT. Coeliac disease, gluten free diet and malignancy. Gut 1976;17:612-619.
16. Freeman HJ, Weinstein WM, Shnitka TK, Piercey JRA, Wensel RH. Primary abdominal lymphoma: Presenting manifestation of celiac sprue or complicating dermatitis herpetiformis. Am J Med 1977;63:585-590.
17. Kato I, Tajima K, Suchi T, et al. Chronic thyroiditis as a risk factor of B-cell lymphoma in the thyroid gland. Jpn J Cancer Res 1985;76:1085-1090.
18. Kassan SS, Thomas TL, Moutsopoulos HM, et al. Increased risk of lymphoma in sicca syndrome. Ann Intern Med 1978;89:888-892.
19. Isomaki HA. Excess risk of lymphoma, leukemia and myeloma in patients with rheumatoid arthritis. J Chronic Dis 1978;31:691-696.
20. Shpilberg O, Friedman B, Azaria M, et al. Primary striated muscle lymphoma presenting in an amputation stump. Isr J Med Sci 1989;25:116-117.
21. Chevalier X, Amoura Z, Viard J-P, et al. Skeletal muscle lymphoma in patients with the acquired immunodeficiency syndrome:a diagnostic challenge. Arthritis Rheum 1993;36:426-427.
22. Laffosse JM, Gomez-Brouchet A, Molinier F, Chiron P, Roché H, Puget J. A case of malignant primary nonHodgkin's lymphoma in skeletal muscle treated by exclusive chemotherapy. Joint Bone Spine 2009;76:86-88.