Skeletal Muscle Involvement in B-Cell Lymphoma: Two Cases Illustrating the Contribution of Imaging to a Clinically Unsuspected Diagnosis

Figure 1

Axial T1 (a), coronal T1 (b), axial T2 (c), sagittal T2 (d), axial T1 FS postcontrast (e), coronal T1 FS postcontrast (f), and coronal T1 FS postcontrast (g) images of the involved lumbar spine and pelvis in the 17-year-old boy from case 1. There is unilateral marked expansion of the right gluteal, piriformis, and paraspinal muscles, exhibiting T1 isointensity and T2 hyperintensity. The muscle enlargement results in effacement of intramuscular fat. The postcontrast images demonstrate diffuse striated enhancement, giving an infiltrative appearance. Enhancing nodules are seen in the adjacent subcutaneous tissues. There is also subcutaneous fat stranding (indicated by the arrow, image (g)). Aside for the enlargement, note the overall preservation of muscle morphology and lack of a focal mass.

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