Primary bone lymphoma: A case report and review of the literature

Abstract

Primary lymphoma of the bone (PLB) primarily arising from the medullary cavity is an extremely rare entity, with only retrospective studies and sporadic cases reported in the literature. The current study presents one case of PLB treated with chemotherapy and radiotherapy, and a review of the literature to elucidate the optimal treatment of PLB. A 73-year-old female presented with pain in the left hip that had persisted for two months. Plain X-ray and magnetic resonance imaging of the left hip showed lytic areas involving the left innominatum. Technetium-99m radionuclide imaging showed increased tracer uptake in the ilium, acetabulum and ischium. An 18F-fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) scan showed high FDG uptake. A fine-needle aspiration biopsy of the lesion was performed, and histopathological and immunohistochemical examination confirmed a diagnosis of B-cell lymphoma. The patient received radiation therapy followed by six cycles of CHOP regimen (1,000 mg cyclophosphamide, 80 mg epirubicine and 2 mg vincristine on day one, and 100 mg prednisone on days one to five, every three weeks) and achieved a complete response, as confirmed by FDG-PET-CT. At present, the patient is in a good condition. This case is noteworthy, as it is a well-documented case in which the patient received successful treatment. This case demonstrates that PLB has an improved prognosis compared with primary lymphoma of other sites; however, combined therapy may further improve the patient outcome.

Primary Bone Burkitt’s like Lymphoma of the Skull Mimicking Meningioma - Case Report and Review of Literature

“…According to the 2002 World Health Organization classification of tumors of soft tissue and bone, the criteria for a diagnosis of PBL are [1] a single skeletal tumor with or without regional lymph node involvement, and [2] multiple bone lesions without visceral or lymph node involvement [1,4].…”

“…It's occurrence in the skull is actually the rarest to find and is seen in only 1% of primary bone lymphoma, while the femur (50%) and pelvis (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)% are the two most common sites, and others include the tibia/ fibula, humerus, spine and scapula [1,2]. Our patient was diagnosed at the age of 26, much younger than the median age of this population which was 48 years in 19 similar cases of primary bone lymphoma of the skull which we reviewed [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

“…PBL has variable cell subtype, molecular features, and diagnosing criteria. It has high cure rates and different treatment plan compared to other primary bone tumors, and thus it is very important to differentiate between them [2]. The PubMed database of the National Library of Medicine and National Institutes of Health, Google Scholar, and Science Direct databases were used to search for published cases meeting the definition of PBL of the skull.…”

Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder Presenting as Primary Bone Lymphoma in a Patient with Rheumatoid Arthritis

“…A physical examination, blood tests, and imaging studies, such as MRI and PET/CT, to exclude synovium inflammation of RA and to detect the bone lesion of PBL were useful in the present case. X-rays typically show focal lytic lesions or permeative destruction often with sclerotic change (6,8,15). Unfortunately, a lesion of PBL may not be detected on X-rays such as in this case (8).…”

“…It accounts for 5% of extranodal lymphomas (1)(2)(3)(4)(5)(6), less than 1% of all non-Hodgkin's lymphomas (3,6,7), and 3% of all primary malignant bone tumors (2,5,8). Patients with rheumatoid arthritis (RA) tend to develop lymphoproliferative disorders (LPD) at a frequency of 2.0-5.5 times higher than that in the general population.…”