Hodgkin lymphoma (HL) is an uncommon malignancy usually limited to the lymph nodes and lymphatic system while extranodal involvement is much less common than in non-Hodgkin lymphoma. The current report presents an unusual case of primary classical HL (cHL), nodular sclerosis type with mixed cellularity in buttock soft tissue of 78-year old man. Primary lymphoma of the gluteal muscle is a rare disease and primary cHL is even rarer. In addition, to this unusual extranodal presentation, the present case highlight a diagnostic challenge in fine-needle biopsy masquerading a low grade sarcoma, primarily myxoinflammatory fibrosarcoma or an inflammatory lesion. However, surgical biopsy and immunohistochemistry guided correct diagnosis that was of major interest for further successful treatment.
TravisWDBanksPMReimanHM.Primary extranodal soft tissue lymphoma of the extremities. Am J Surg Pathol1987;
11: 359–366.
3.
GuermaziABricePKervilerE, et al.
Extranodal Hodgkin disease: spectrum of disease. Radiographics2001;
21: 161–179.
4.
ZuccaE.Extranodal lymphoma: a reappraisal. Ann Oncol2008;
19: 77–80.
5.
LiZ-MZhuY-JXiaY, et al.
Clinical characteristics of the patients with Hodgkin’s lymphoma involving extranodal sites. Chin J Cancer2012;
31: 342–347.
6.
ModiYThomasDShaabanH, et al.
Nodular sclerosis Hodgkin’s lymphoma with breast involvement: case report and review of the literature. J Nat Sci Biol Med2014;
5: 467–469.
7.
ZarnescuNOIliesiuAProcopA, et al.
A challenging case of primary breast Hodgkin’s lymphoma. Maedica J Clin Med2015;
10: 44–47.
8.
YangZEsebuaM.Challenges in diagnosis of primary classical Hodgkin lymphoma of parotid gland by fine needle aspiration: a rare case report and review of the literature. NAJ Med Sci2016;
9: 83–87.
9.
WilliamsTPRaessPWBrazielR, et al.
Primary extranodal nodular lymphocyte predominant Hodgkin lymphoma involving the thyroid. Head Neck Pathol2020;
14: 550–553.
10.
KhurooMS.Hodgkin lymphoma rectosigmoid in a patient with ulcerative colitis on long-term azathioprine therapy. BMJ Case Rep2014. Epub ahead of print 20 May 2014. DOI: 1136/bcr-2013-203354.
11.
VasudevanJANairRANambiarKR.Primary classical Hodgkin lymphoma of rectum: report of an extremely rare case and review of the literature. Indian J Pathol Microbiol2017;
60: 412–414.
12.
RanganAGrahnSWFeldmanAL.Nodular lymphocyte predominant Hodgkin lymphoma of the ileum. Case Report Pathol2017; 2017: Article 5981013. DOI: 10.1155/2017/5981013.
13.
MenYSunXWeiD, et al.
Primary extranodal head and neck classical Hodgkin lymphoma: a rare clinical case report. Exp Ther Med2016;
12: 1007–1011.
14.
KaurHNewlandsC.A rare case of extranodal Hodgkin’s lymphoma of the palate. Oral Surg2018;
11: 228–234.
15.
GlassAGKarnellLHMenckHR.National Cancer Data Base report on Hodgkin’s lymphoma. Cancer1997;
80: 2311–2320.
16.
SwerdlowSHCampoEHarrisNL, et al. 2017. WHO classification of tumours of hematopoietic and lymphoid tissues. Revised 4th ed.
Lyon, France:
IARC.
17.
ThomasAGVaidhyanathRKirkeR, et al.
Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol2011;
197: 357–364.
18.
IlicaATKocacelebiKSavasR, et al.
Imaging of extranodal lymphoma with PET/CT. Clin Nucl Med2011;
36: e127-138–e138.
19.
SonninoRKambourisAA.Malignant lymphoma presenting in gluteal muscle: case report and brief of the literature. Henry Ford Hosp Med J1988;
36: 61–63.
20.
KatsuraMNishinaHShigemoriY, et al.
Extranodal lymphoma originating in the gluteal muscle with adjacent bone involvement and mimicking a soft tissue sarcoma. Int J Surg Case Rep2015;
7: 161–164.
21.
LiXMZhangHSDaiX, et al.
Primary extra-nodal non-Hodgkin lymphoma in buttock soft tissue. Medicine (Baltimore)2018;
97: e13550.
22.
UtkanGBuyukcelikAYalcinB, et al.
Extranodal Hodgkin disease presenting with gluteal mass and hypercalcemia. South Med J2006;
99: 1149–1150.
23.
CardellaJFBakalREBurkeDR, et al.
Quality improvement guidelines for image-guided percutaneous biopsy in adults: Society of cardiovascular & interventional radiologx standards of practice committee. J Vasc Interv Radiol1996;
7: 943–946.
De KervilerEGuermaziAZgdanskiAM, et al.
Image-guided core-needle biopsy in patients with suspected or recurrent lymphomas. Cancer2000;
89: 647–652. 200
26.
LeeJHKimYChoiJW, et al.
Prevalence and prognostic significance of Epstein-Barr virus infection in classical Hodgkin’s lymphoma: a meta-analysis. Arch Med Res2014;
45: 417–431.
27.
KilicarslanAOzturkVSeturk YikilmazA, et al.
Evaluation of the prognostic importance of c-myc and bcl-2 expression and the presence of Epstain-Barr virus in classical Hodgkin lymphoma. Turk Patoloji Derg2018;
34: 199–201.
28.
SouzaEMBaiocchiOCZanichelliMA, et al.
Impacz of Epstein-Barr virus in the clinical evolution of patients with classical Hodgkin’s lymphoma in Brazil. Hematol Oncol2010;
28: 137–141.
29.
KwonJMParkYHKangJH, et al.
The effect of Epstein-Barr virus status on clinical outcome in Hodgkin’s lymphoma. Ann Hematol2006;
85: 463–468.
30.
PaesFMKalkanisDGSiderasPA, et al.
FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics2010;
30: 269–291.
