Primary lymphoma of bone: relationship of radiographic appearance and prognosis.

Abstract

A retrospective review was made of the pretreatment radiographs of 20 patients with well-documented primary lymphoma of bone. Nine radiographic signs were defined, and the presence or absence of each was recorded for each patient. When the radiographic findings were compared with disease-free survival for each patient, it was found that patients who had a relapse had a higher mean number of positive radiographic signs than those who remained disease free (p less than 0.02). Also, those who relapsed early had more positive signs than those who relapsed late (p less than 0.05). Certain signs, i.e., pathologic fracture, layered periosteal new bone, broken periosteal new bone, cortical breakthrough, soft-tissue mass, and soft-tissue swelling, were more helpful than others for making a prognosis. These signs appear to be related to radiologic evidence of imminent or actual soft-tissue extension of the tumor.

Primary Bone Lymphoma: Radiographic–MR Imaging Correlation

“…Occasionally, the lesion may manifest with focal lytic areas with well-defined margins (Fig 3). Cortical breakthrough, pathologic fractures (in about 25% of our cases) (Fig 4a), and soft-tissue masses represent a more aggressive pattern of involvement and a poorer prognosis (19). Cortical breakthrough, which refers to a sudden interruption in the continuity of the cortex, was better seen at computed tomography (CT) in our experience (Fig 5b) and correlated with a more aggressive tumor.…”

“…Although the latter opinion may be reasonable given the wide spectrum of findingsfrom a near-normal-appearing bone to a focal lytic lesion with geographic margins to a mixed sclerotic-lytic lesion to a diffusely permeative process with cortical destruction and soft-tissue involvement-there are some peculiar features worth noting. One such pattern described as being typical of lymphomatous bone involvement is a solitary lytic lesion near the end of a long bone that has a permeative or moth-eaten pattern of destruction and aggressive periosteal reaction (19). This pattern is a feature of round cell tumors (including Ewing sarcoma and multiple myeloma), of which lymphoma is an example.…”

“…It is believed to result from an osteoclast-stimulating factor. The lytic pattern may be permeativecharacterized by numerous small, elongated rarefactions that are parallel to the long axis of the bone and relatively uniform in size- Fig 2) or moth-eaten-a pattern of many medium to large areas of radiolucency in a poorly marginated area of bone (19). Occasionally, the lesion may manifest with focal lytic areas with well-defined margins (Fig 3).…”

Aggressive Periosteal Nonhodgkin’s Lymphoma in a 3 Years Old Boy

“…Microscopically round to oval cells with indistinct cytoplasmic margin and round to oval nucleus displaying pleomorphism, hyperchromatism and abnormal mitosis. [7] Histopathologically features of malignant round cell tumour favoring malignant lymphoma, large cell type. Chemotherapy is the treatment of choice for this patient.…”

Primary Lymphoma of the Bones of the Foot: Management of Two Cases

“…In contrast, secondary involvement from disseminated non-Hodgkin's lymphoma usually affects the axial ~k e l e t o n .~*~~~~ Foot & Ankle/Vol. 11 The treatment modality and the prognosis are entirely different in PLB as compared to secondary bone involvement from disseminated non-Hodgkin's lymphoma. Therefore, it is very important to distinguish between the two.…”