Primary bone lymphoma
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Primary bone (skeletal/osseous) lymphoma (PBL) is a less common manifestation of lymphoma than secondary involvement from disseminated lymphoma. It is rare, accounting for <5% of bone tumors and <1% of non-Hodgkin lymphoma.
PBL is defined as the presence of lymphoma isolated to one bone without distant spread for six months after diagnosis. Multifocal PBL is less common and occurs with lymphoma is confined to two or more bones, again without distant spread for six months 1.
PBL can affect any age group, with peak incidence in (50-60) year-olds. It is rare in children <10 years old. There is a slight male predominance (M:F = 1.5:1) 2.
PBL has non-specific features and the affected bone may be normal or affected by lytic, sclerotic or mixed pattern. The most common is a lytic pattern with permeative bone destruction and a wide zone of transition 1. Cortical thickening and periosteal reaction may also be seen.
Associated soft tissue masses are common. Bone marrow changes include 2:
- T1: low signal
- T2: high signal
Treatment and prognosis
Five-year survival rate has been reported at ~ 80%, much better than other bone tumors 2.
For plain film presentation of permeative bone destruction consider 1:
- 1. Lim CY, Ong KO. Imaging of musculoskeletal lymphoma. Cancer Imaging. 2013;13 (4): 448-57. doi:10.1102/1470-7330.2013.0036 - Free text at pubmed - Pubmed citation
- 2. Krishnan A, Shirkhoda A, Tehranzadeh J et-al. Primary bone lymphoma: radiographic-MR imaging correlation. Radiographics. 2003;23 (6): 1371-83. doi:10.1148/rg.236025056 - Pubmed citation
- 3. Maruyama D, Watanabe T, Beppu Y et-al. Primary bone lymphoma: a new and detailed characterization of 28 patients in a single-institution study. Jpn. J. Clin. Oncol. 2007;37 (3): 216-23. doi:10.1093/jjco/hym007 - Pubmed citation