Primary lymphoma of bone. Correlation of magnetic resonance imaging features with cytokine production by tumor cells

Abstract

Background. Primary lymphoma of bone is a rare, aggressive neoplasm that can present with a large, soft‐tissue mass despite minimal evidence of cortical destruction on plain radiographs. Methods. High resolution magnetic resonance imaging (MRI) examinations of four patients with primary lymphoma of bone were reviewed retrospectively, and in each case intramedullary tumors demonstrated “penetrating channels” extending through the cortex. The MRI studies were correlated with the histopathologic assessment of the tumor for each patient. Immunohistochemistry was performed for immunophenotyping and for cytokine expression by tumor cells. The cytokines that were investigated were interleukin‐1, interleukin‐6, and tumor necrosis factor‐alpha, molecules known to regulate osteoclastic activity. Results. The linear cortical foci noted on MRI correlated with the histopathologic findings of tumor‐associated cutting cones, in proximity to osteoclastic bone resorption. Immunohistochemical stains showed a B‐cell phenotype for each tumor and positive immunoreactivity in tumor cells for cytokine mediators that stimulate osteoclastic activation. Conclusions. These findings indicate that the tumor cells in these cases produce soluble cytokine mediators that may regulate extensive osteoclastic activity. In primary lymphoma of bone, tumor activation of osteoclastic resorption, with production of tumor tunnels through the cortex, may represent one of the mechanisms by which lymphoma escapes the intramedullary space and forms large, soft‐tissue masses without extensive cortical destruction. Cancer 1995;75:973‐80.

Primary Bone Lymphoma: Radiographic–MR Imaging Correlation

“…Interestingly, the pattern of extensive marrow disease and surrounding soft-tissue masses but without extensive cortical destruction has been reported nearly exclusively in round cell tumors such as primary bone lymphoma, multiple myeloma, and Ewing sarcoma (Fig 11c) (1,21). One explanation for this finding is the spread of tumor cells from the marrow through small vascular channels that run through the cortex into the surrounding soft tissue (22).…”

Case of polyostotic primary bone lymphoma successfully treated with immunochemotherapy and consolidation radiotherapy

“…The mechanism by which PBL traverses an apparently intact cortex is through cortical tunnelling, which was demonstrated by Hicks et al 18 In that study, MRI, histopathological and immunohistochemical correlation revealed cutting cones with marked osteoclastic activity and extensive bone resorption in the form of narrow channels through cortical bone, which were filled with tumour cells.…”

Analysis of the molecular mechanism underlying bone marrow necrosis with acute lymphoblastic leukemia

“…The difference in these cytokine profile patterns is thought to influence the laboratory findings. In BMN, these cytokines and chemokines may be produced by systemic ALL cells and accessory cells, as described previously [10]; however, the possibility that massive cell death induced these responses, especially in the release of inflammatory cytokines such as TNF-α, IL-1β, and IL-6, could not be excluded. Additionally, we examined the levels of HMGB1, which was originally characterized as a non-histone, nuclear DNA-binding protein [11,12].…”