Case report: Primary bone lymphoma presenting as a painful supraclavicular lump

Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis

“…The clinical features of PBL are generally unspecific, frequently leading to a delay in diagnosis, and, thus, a high index of suspicion is required [ 7 , 18 ]. The most common symptom of PBL is local bone pain in the affected area, which is not relieved by rest and has been characterized as insidious, intermittent and progressively worsening [ 2 , 3 , 4 , 7 , 9 , 15 , 18 , 19 , 20 , 21 , 22 , 23 ]. Other less common manifestations include soft tissue edema, palpable mass, pathological fracture, restricted range of motion in the involved articulation and “B” symptoms, namely fever, night sweats and unintentional weight loss [ 2 , 3 , 4 , 8 , 11 , 18 , 19 , 22 , 23 , 24 , 25 ].…”

“…PBL can develop in any part of the skeleton, although is most common in the femur, humerus, tibia, spine and pelvis [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 17 , 20 , 21 , 22 , 24 , 31 ]. Other less common sites of occurrence include the skull, forearm, scapula, clavicle, patella, hands and feet [ 3 , 4 , 9 , 10 , 17 , 21 , 25 ].…”

“…PBL can develop in any part of the skeleton, although is most common in the femur, humerus, tibia, spine and pelvis [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 17 , 20 , 21 , 22 , 24 , 31 ]. Other less common sites of occurrence include the skull, forearm, scapula, clavicle, patella, hands and feet [ 3 , 4 , 9 , 10 , 17 , 21 , 25 ]. Interestingly, younger age has been associated with an appendicular location of PBL, which could be explained by the active bone marrow present in the long bones of younger patients [ 24 ].…”

“…The role of ultrasound examination in cases of PBL is limited. It can often depict a soft tissue mass associated with PBL and also demonstrate the typical imaging pattern of bone cortex preservation despite the extraosseous extension of the lesion [ 21 ]. Ultrasonography, however, can be helpful in the establishment of a PBL diagnosis via ultrasound-guided biopsy [ 21 , 25 ].…”

“…Treatment of PBL is based on systemic therapy and the current modalities include chemotherapy or immunochemotherapy with or without radiotherapy, resulting in a 5-year overall survival (OS) of approximately 70% [ 2 , 7 , 8 , 9 , 10 , 19 , 20 , 21 , 23 ]. Anthracycline-based, multiagent chemotherapy comprising cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) with or without the addition of rituximab (R-CHOP) is the preferred modality [ 2 , 9 , 10 , 19 , 20 , 22 , 23 , 24 , 95 ].…”