Secondary involvement of the bone with lymphoma

Last revised by Daniel J Bell on 20 Aug 2019

Secondary involvement of the bone with lymphoma, also referred as secondary bone lymphoma, is much more common than primary bone lymphoma, occurring in ~15% of disseminated lymphomas.

Secondary bone lymphoma is defined as lymphoma involving the bone with nodal disease occurring within six months or secondary lymphoma involving the bone at least six months after diagnosis.

Secondary bone involvement is more common in children (25%) 1

Bone pain and/or pathological fracture

Secondary bone involvement can result from direct spread from nodal disease or hematogenous metastases. The axial skeleton is more often affected than the appendicular skeleton 2. The most frequent locations are 1,3:

  • lytic lesion(s)
  • permeative bone destruction with cortical breach
  • adjacent soft tissue mass(es)

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