Age / Sex : 64 / F

Diffuse large B cell lymphoma

Discussion

Findings:

MRI shows heterogeneously enhancing cutaneous/subcutaneous mass with thorny margin at medial aspect of the right elbow.

Differential Diagnosis: Squamous cell carcinoma, dermatofibrosarcoma protuberans 

Diagnosis: Diffuse large B cell lymphoma 

Discussion:

Cutaneous lymphoma: a heterogeneous group of T cell or B cell origin

MRI

• - isointense on T1- and T2-weighted images, probably due to the high cellular composition


• - margin has a tendency of thorny appearance into the subcutaneous fat, suggesting lymphatic spread


• - homogeneous enhancement


• - associated abnormalities in adjacent osseous structures or lymph nodes often can be helpful in the differential diagnosis, although the imaging features of cutaneous lymphoma might be nonspecific 

References:

Kim JH, Kim JY, Chun KA, Jee WH, Sung MS. MR imaging manifestations of skin tumors. Eur Radiol. 2008;18:2652-2661.

Beaman FD, Kransdorf MJ, Andrews TR, Murphey MD, Arcara LK, Keeling JH. Superficial soft-tissue masses: analysis, diagnosis, and differential considerations. Radiographics. 2007;27:509-523.