Soft tissue lymphoma

Abstract

Whenever a soft tissue mass is encountered, which is iso- to slightly hyperintense on Tl-WI and intermediate to hyperintense on T2-WI with a diffuse infiltrative pattern extending into different muscle groups, lymphoma should be included in the differential diagnosis. There are in general no signs of necrosis or hemorrhage before treatment. A soft tissue mass wrapped around the bone is especially suspicious for extranodal primary soft tissue lymphoma. Determining the local extent requires MRI, and distant spread may be studied by CT of the abdomen and thorax, MRI of the brain and skeletal scintigraphy and/or PET-CT scan, and blood tests. For primary nodal and primary extranodal involvement, PET-CT is preferred for staging of FDG-avid lymphomas, and CT scan is preferred in all other scenarios. Contrast-enhanced CT is preferred for radiation therapy planning. Variably FDG-avid histologies should be staged with a CT scan.