Primary bone lymphoma: pictorial essay.

Flávio Scavone Stefanini ,Almir Galvão Vieira Bitencourt,Wagner Santana Cerqueira,Franklin Wilson Caires Gois,Tiago Cesar Silva Borba De Arruda

doi:10.1590/0100-3984.2019.0137

Flávio Scavone Stefanini , Almir Galvão Vieira Bitencourt + Show 3 more

Open Access

https://doi.org/10.1590/0100-3984.2019.0137

Copy DOI

Journal: Radiologia brasileira	Publication Date: Jan 1, 2020
Citations: 1	License type: CC BY 4.0

Affiliation: AC Camargo Hospital

Abstract

Primary bone lymphoma is a rare neoplasm that can initially present as local pain, a palpable mass, and pathologic fracture. It can also be discovered as an incidental finding on an imaging examination. It is defined as a bone marrow tumor with no involvement of other sites, lasting at least six months. The diagnosis is confirmed by biopsy and immunohistochemical analysis. Although the imaging characteristics are nonspecific, there are certain findings that, when correlated with clinical and epidemiological aspects, can increase the level of suspicion of primary bone lymphoma. The classic imaging aspect is a bone lesion with a soft-tissue component that preserves the cortical layer more than would be expected given the invasive nature of the lesion. Magnetic resonance imaging is the best imaging method to evaluate the extent of involvement of adjacent compartments, whereas computed tomography depicts the cortical layer in greater detail, as well as being an important tool for biopsy guidance. Other imaging modalities are also discussed, such as X-ray, ultrasound, bone scintigraphy, and positron emission tomography/computed tomography. The aim of this paper is to describe the most common findings obtained with the various imaging methods used in patients with a confirmed diagnosis of primary bone lymphoma.

Highlights

Primary bone lymphoma (PBL) is a rare disease, accounting for only 3–7% of all primary bone neoplasms, approximately 5% of extranodal lymphomas, and less than 1% of all non-Hodgkin lymphomas(1,2), diffuse large Bcell lymphoma being the most common(1–4)
The following criteria for the diagnosis of PBL are widely accepted(1): the primary site of tumor origin being in the bone marrow, no other site indicating the existence of the lesion on physical or imaging examination; no lymphoma being identified at any other site within the first six months after the diagnosis of PBL; the diagnosis being confirmed by pathology and immunohistochemistry; a diagnosis of malignant lymphoma, with the exception of PBL and secondary bone lymphoma, having been excluded
Originating from the bone marrow, PBL is a neoplasm that has widely variable presentations on imaging, and the findings can overlap with those numerous non-neoplastic conditions, as well as with those of other benign or malignant neoplasms

Summary

INTRODUCTION

Primary bone lymphoma (PBL) is a rare disease, accounting for only 3–7% of all primary bone neoplasms, approximately 5% of extranodal lymphomas, and less than 1% of all non-Hodgkin lymphomas(1,2), diffuse large Bcell lymphoma being the most common(1–4). They are extremely rare in the pediatric and young adult populations(2). The thorough evaluation of specific radiological patterns can increase the level of suspicion for PBL before tissue biopsy.

GENERAL IMAGING CHARACTERISTICS

COMPUTED TOMOGRAPHY

Findings

CONCLUSION