原发性骨骼肌淋巴瘤临床罕见，而原发性骨骼肌的非特指型外周T细胞淋巴瘤更为罕见，因临床表现缺乏特异性，易被误诊和漏诊，目前主要依靠¹⁸F-FDG-PET/CT高代谢特征筛查病灶，并通过活组织检查确诊。本文报道1例以口咽部溃疡伴发热为主要临床表现的病例，多次溃疡部位活检未见异性细胞，PET/CT提示双小腿肌肉和咽部等多处代谢不均匀增高，最终经小腿肌肉活检、HE染色结合免疫组化确诊为原发骨骼肌非特指型外周T细胞淋巴瘤。该病例诊断过程曲折，提示临床需提高对此类罕见病的认知，以期实现早期诊断并改善预后。

Primary skeletal muscle lymphoma is rare, and primary skeletal muscle non-specified peripheral T-cell lymphoma (PTCL-NOS) is even rarer. It is prone to be misdiagnosed and missed as its lack of specificity of clinical manifestations. At present, its diagnosis primarily relies on ¹⁸F-FDG-PET/CT to screen hypermetabolic lesions and tissue biopsy to confirm it. This article reports a case of oropharyngeal ulcers accompanied by fever as the main clinical manifestations, while there were no atypical cells found in multiple biopsies of the ulcer sites. PET/CT showed heterogeneous hypermetabolism in the calf muscles of two legs and the pharynx. Finally, the patient diagnosis was confirmed as primary skeletal muscle PTCL-NOS through calf muscle biopsy, hematoxylin and eosin staining (HE) staining and immunohistochemistry. The diagnostic process of the case was challenging. It suggests that recognition of primary skeletal muscle PTCL-NOS needs to be improved to achieve early diagnosis and better prognosis.