Presentation
Pain and swelling in left ankle for 12 months.
Patient Data
Osteolytic lesion of the calcaneus, with an undefined transition zone, in some areas defined with a halo of sclerosis, with intralesional sclerotic beams, thinning of the lower cortical bone, and some areas suggesting cortical discontinuity. There is bone textural alteration of the talus, questioning infiltrative bone lesion.
Heterogeneous insufflative bone lesions with cystic stores inside, with sparse cortical rupture in the calcaneus and talus, the largest of which affects the calcaneal base, measuring around 6.0 x 2.0 x 2.6 cm. There is also a dominant lesion affecting the head and body of the talus, with cortical rupture, measuring around 4.2 x 3.8 x 3.2 cm.
Post-treatment showed regression of the lytic component and formation of a slightly fibrous mixed matrix. There were no fractures during treatment.
Case Discussion
The patient was assessed for pain and swelling in the left ankle 12 months previously, with no report of trauma. After imaging, he underwent a bone biopsy of the lateral aspect of the calcaneus using a core needle.
The biopsy revealed an undifferentiated small cell neoplasm, with immunohistochemical staining for CD45+, CD20+ and Ki67 80%, compatible with diffuse large B-cell non-Hodgkin's lymphoma.
The patient was started on onco-hematological treatment and did not require surgery.
Follow-up was carried out using PET-CT and he finished treatment after around 7 months, with no local complaints.
Unable to process the form. Check for errors and try again.