Non-Hodgkin lymphoma of bone

Case contributed by Dr Domenico Nicoletti

Presentation

Patient with left hip pain and asthenia

Patient Data

Age: 65
Gender: Male
Modality: X-ray

7 12 24

Thickened appearance of left acetabular sn refer to coxarthrosis.

Modality: X-ray

12 12 5

Coxo-femoral implant arthroplasty sn. Extension of the osteostrutturale rehash iliac wing joint sn.

Modality: X-ray

4 13 16

Bony rearrangement mixed type extended to the pelvic ring sn.

Modality: CT

TC PELVIS 9 1 13:

solid mass at level emipelvis sn with structural subversion of the bone of mixed type, prevalently lytich.

 

Laboratory: normal alkaline phosphatase!!

 

later: bony biopsy

therapy: chemo and radiotherapy

Modality: CT

TC PELVIS 10 5 14

LNH in complete remission

Modality: X-ray

9 10 14

Remission of lymphoma pathology.

Case Discussion

The primitive bone Lymphoma usually presents as a first symptom pain in the affected premises; at the beginning the typical signs of fever, malaise, weight loss may be absent, though, however, appear during the course of the disease.Later, at the level of the affected bone is a swelling.

In the early stages appears a permeative type osteolysis and infiltrating; then there are also areas of higher density due to the reaction of the host bone. The bone cortex appears gradually infiltrated and undermined by the tumor with bone laminar reaction (Codman's triangle); bone structure weakens progressively and pathological fractures may occur. 

The bone scans and PET SCANS are always highly positive (unlike the Myeloma) and is always performed in the suspicion of lymphoma because it recognizes any other skeletal locations.

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Case Information

rID: 31604
Case created: 17th Oct 2014
Last edited: 5th Oct 2015
Inclusion in quiz mode: Included

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