Primary bone lymphoma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painfull swelling of the left leg.

Patient Data

Age: 50 years
Gender: Male
mri

Abnormal signal of the tibial bone marrow extending from the proximal epiphysis up to the distal aspect of the diaphysis of low signal on T1, inhomogeneous high signal on T2 with heterogeneous enhancement on post-contrast sequences. Thinning with irregularity of the cortical bone with no cortical break seen. Normal appearance of the fibula.

Circumferential periosseous soft tissue mass of the middle tibial 1/3 (height = 16 cm, thickness = 2 cm) of iso-to low signal to the muscles on T1, high signal on T2 with heterogeneous enhancement displacing the surrounding muscles with effacement of the fat planes. Anteriorly there is infiltration of the subcutaneous and cutaneous tissues with skin ulceration.

Case Discussion

MRI features of an extensive tumoral infiltration of the tibial bone marrow with associated circumferential periosseous soft tissue component.

The patient underwent an ultrasound-guided biopsy, that confirm the diagnosis of a primary bone lymphoma (diffuse large B cell lymphoma).

 

Additional contributor: ZE. Boudiaf, MD, CHU, Constantine, Algeria

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