Large B-cell lymphoma mimicking iliopsoas abscess following open revision of proximal femur infected non-union: a case report

An Update on Implant-Associated Malignancies and Their Biocompatibility

Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.

Extranodal Diffuse Large B-Cell Lymphoma (DLBCL) Presenting as Diffuse Joint Pain: A Diagnostic Dilemma

Diffuse Large B-Cell Lymphoma (DLBCL) of bone is a rare presentation of Non-Hodgkin Lymphoma (NHL), which remains asymptomatic or present late in clinical course as bone pain or pathological fracture. We report a case of a 15-year-old male child presenting with diffuse joint pain and swelling over his left shoulder and elbow, associated with B symptoms. Radiological examination revealed lytic lesions in multiple bones along with collection along the left iliopsoas and hip joint, suggestive of infective etiology. The diagnostic dilemma was resolved on biopsy, which confirmed DLBCL involving bones and soft tissue.

Diffuse large B-cell lymphoma mimicking chronic osteomyelitis of the ankle joint: A case report

Lymphoma is the seventh most common type of malignancy in both males and females. It may develop in any location where lymphomatous tissue exists. Although extranodal presentation in the lower limb and pelvis are uncommon, it could present with diverse manifestations. We report an unusual case of primary extranodal large B-cell lymphoma of the ankle joint initially presumed to be a chronic osteomyelitis. This case report discusses the impact of imaging studies on decision-making and highlights the need to consider malignancy in chronic infections.

Intramuscular lymphoma: uncommon presentation of Hodgkin's disease

Extranodal presentation in lymphoproliferative disorders is a well-recognised entity. However, musculoskeletal involvement is extremely rare. We describe the case of a 64-year-old farmer who presented to us with constitutional symptoms of fever, loss of weight and loss of appetite for 2 years and physical examination revealing generalised lymphadenopathy with hepatosplenomegaly. Biopsy of an axillary lymph node showed mixed cellularity variant of Hodgkin's lymphoma. CT of the thorax and abdomen revealed a collection in the right psoas muscle. Guided biopsy of the psoas deposit was suggestive of Hodgkin's lymphoma. PCR and cultures for Mycobacterium tuberculosis tested negative. Here we describe a rare presentation of Hodgkin's lymphoma with intramuscular involvement.

Development of Primary Diffuse Large B-Cell Lymphoma Around an Internal Fixation Implant After Lumbar Fusion Surgery: A Case Report and Review of the Literature

BACKGROUND

Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed primary non-Hodgkin lymphoma of the spine and can induce spinal compression. Reports of lymphoma arising in bone adjacent to metallic prostheses are increasing. However, to our knowledge, DLBCL arising from a scar after lumbar fusion surgery has not been reported previously.

CASE DESCRIPTION

A 63-year-old man complained of a 2-month history of severe pain in the back and both legs, radiating down to the ankle, similar to sciatica with a past history of L2-S1 decompression and fusion 7 years ago. Imaging revealed an irregular mass in the epidural space and around the internal fixation surgical site, which was initially diagnosed as an epidural infectious abscess. Most of the lesion was completely excised and a detailed immunohistopathologic analysis was performed revealing the diagnosis of a DLBCL. After surgery and chemotherapy, he was discharged without complications. Unfortunately, he died 2 years later because of brain metastasis.

CONCLUSIONS

This case highlights the need to consider malignancy in the differential diagnosis and carefully examine surgical specimens in revision surgery. Further understanding of the role of metal implants in the development of lymphoma is required.