case_images: PMC11763905_01
case_images: Both lower limbs showing hemosiderin discoloration, a knee replacement scar on anterior aspect of the right knee. Right medial, anterior lower portion of the leg showing erythema with edema and wooden hard texture. Pedal pulses were palpable.
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case_images: PMC11763905_01_gr1.jpg
case_images: fig1
case_images: Magnetic resonance imaging scan of the lower portion of the right leg, demonstrating multiple soft tissue nodules within the subcutaneous tissue and muscles, spanning the facial planes, with the largest one measuring 9 cm. Heterogeneous intermediate signal on T2 image raised the suspicion of lymphoma.
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case_images: PMC11763905_01_gr2.jpg
case_images: fig2
case_images: A magnetic resonance imaging scan was arranged (Fig 2).
case_images: Core biopsy from mass lesion, right calf (A), viable tumor (V) with a necrotic segment (N) and intervening fibrosis (F). B, Center of image (A). C, The viable tumor cells; morphologically these are large atypical lymphoid cells, with rounded nuclei and multiple nucleoli. D, Positive (brown) staining in scattered small T cells but not the tumor cells. E, Positive staining in the tumor cells consistent with B-cell origin. F, The high proliferation index of the neoplastic B cells. (A and C, Hematoxylin-eosin stain; D, CD3 immunostain; E, CD20 immunostain; F, MIB1 immunostain; original magnifications: A, x40; B and D-F, x100; C, x400.)
case_images: gr3.jpg
case_images: PMC11763905_01_gr3.jpg
case_images: fig3
case_images: Based on the magnetic resonance imaging findings, 2 core biopsies were taken from the mass lesions, which revealed a partly necrotic high-grade B-cell lymphoma (Fig 3).