PET/CT Imaging for Solitary Primary Bone Lymphoma of Thoracic Vertebra

Abstract

Primary bone lymphoma without classic nodal lesions or advanced disease may be mistaken for other osseous diseases, especially when involving a single bone site. In this patient, a series of imaging modalities including MRI, bone scan, and 18F-FDG PET/CT revealed only 1 solitary osseous lytic lesion with abnormal uptake in the third thoracic vertebra, suggesting a primary skeletal malignancy. The subsequent histopathologic examination confirmed the diagnosis of diffuse large B-cell lymphoma. After chemotherapy, he achieved an excellent clinical and metabolic response.

FDG PET/CT Showing a Primary Lymphoma of the Sternoclavicular Joint

“…4 Some studies have reported other sites involved in extranodal DLBCL, such as heart, breast, bone, pancreas, and genitourinary system. [5][6][7][8][9] In our case, the primary DLBCL involved the sternoclavicular joint, demonstrating intense FDG uptake on PET/CT. The sternoclavicular joint is commonly involved in rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, and Tietze syndrome.…”

“…The common sites of extranodal DLBCL are gastrointestinal tract, skin, and soft tissues 4 . Some studies have reported other sites involved in extranodal DLBCL, such as heart, breast, bone, pancreas, and genitourinary system 5–9 . In our case, the primary DLBCL involved the sternoclavicular joint, demonstrating intense FDG uptake on PET/CT.…”

Solitary Lymph Node Metastasis From a Malignant Peripheral Nerve Sheath Tumor of the Thoracic Vertebra Revealed on FDG PET/CT

“…Our case reported a rare phenomenon manifesting as solitary axillary lymph node metastasis for primary bone MPNST. Similar imaging findings in the vertebral column on PET/CT should consider the possibility of lymphoma, 6,7 chordoma, 8 metastasis, 9 epithelioid hemangioma, 10 tenosynovial giant cell tumor, 11 myeloma, 12 and Rosai-Dorfman disease 13 . This case highlights that solitary lytic thoracic vertebral lesion with intense FDG uptake should regard MPNST as a differential diagnosis and that FDG PET/CT has an important role in the initial staging of MPNST 14–16 …”

Solitary Malignant Peripheral Nerve Sheath Tumor of Lumbar Vertebra Mimicking Metastatic Malignancy

“…Nevertheless, it is difficult to correctly interpret a solitary spinal increased FDG uptake. Various etiologies have also been well described, including metastatic glioblastoma, chordoma, lymphoma, Langerhans cell histiocytosis, Rosai-Dorfman disease, and giant cell tumor 9–14 . The current case indicates that MPNST should be considered as one of the possible causes when a solitary high FDG uptake in vertebra lesion was noted on PET/CT images.…”