A patient with persistent foot swelling after ankle sprain: B-Cell lymphoblastic lymphoma mimicking soft-tissue sarcoma

Crystal Montgomery-Goecker, Andrew A. Martin, C. Timmons, D. Rakheja, V. Rajaram, H. Luu
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Abstract

We describe a case of B-cell lymphoblastic lymphoma with an unusual clinical presentation. A 15-year old male with no significant past medical history presented with persistent foot swelling after an ankle sprain. Imaging revealed a mass in the right foot, which was resected and revealed a diffuse infiltrate of B-lymphoblasts. Peripheral blood and bone marrow examinations revealed no abnormalities. These findings were consistent with B-cell lymphoblastic lymphoma, which is an uncommon disease, accounting for only 2% of lymphomas. This case is a reminder that hematolymphoid malignancies can have presentations that mimic sarcomas with no visible peripheral blood or bone marrow involvement. In addition to describing the clinical and histologic features of this case, we also discuss the challenges that can be encountered when establishing a diagnosis of B lymphoblastic lymphoma
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一例踝关节扭伤后持续足部肿胀患者:模拟软组织肉瘤的b细胞淋巴母细胞淋巴瘤
我们报告一个临床表现不寻常的b细胞淋巴母细胞淋巴瘤病例。15岁男性,既往无明显病史,踝关节扭伤后出现持续性足部肿胀。影像显示右脚肿块,切除后发现b淋巴细胞弥漫性浸润。外周血及骨髓检查未见异常。这些发现与b细胞淋巴母细胞淋巴瘤一致,b细胞淋巴母细胞淋巴瘤是一种罕见的疾病,仅占淋巴瘤的2%。这个病例提醒我们,淋巴细胞恶性肿瘤可以有类似肉瘤的表现,没有可见的外周血或骨髓受累。除了描述本病例的临床和组织学特征外,我们还讨论了在确定B淋巴母细胞淋巴瘤诊断时可能遇到的挑战
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