The authors retrospectively reviewed 19 patients who presented with ly
mphoma as soft tissue masses, without evidence of lymph node or skin i
nvolvement. Sites of involvement included lower extremity (seven), upp
er extremity (six), chest wall (three), gluteal region (two), and fron
tal subgaleal region (one). Histological and immunophenotypic studies
revealed 12 large cell lymphomas (11 B cell and one T cell), two small
noncleaved cell lymphomas (B-cell phenotype), and five low grade B-ce
ll lymphomas (two small lymphocytic and three follicular mixed lymphom
as). Patients with large cell lymphoma, including seven patients with
stages I and II and five patients with stage IV, were treated with ant
hracycline-based chemotherapy, with or without radiation therapy. One
half of these patients are dead of disease, including four of seven wi
th low stage disease. The two patients with small noncleaved cell lymp
homa had stage IE disease and were treated with chemotherapy, one died
at 11 months, and the other is alive and disease free at 65 months. P
atients with low grade B-cell lymphoma included four stage IE patients
who were treated with radiation and one stage IV patient treated with
chemotherapy. Two patients are alive and disease free, and three are
dead of unrelated causes. The authors conclude that malignant lymphoma
s initially diagnosed in soft tissues are most commonly large cell lym
phomas with a B-cell phenotype. (C) 1996 by W.B. Saunders Company