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Lymphoma of Bone
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Primary lymphoma of bone (PLB)
        • Synonyms

          • Reticulum cell sarcoma, primary non-Hodgkin lymphoma of bone, primary lymphoma of bone, osteolymphoma, lymphosarcoma
        • Definitions

          • Neoplasm composed of malignant lymphoid cells
          • Divided into 1° or 2° lymphoma of bone
            • PLB
              • Single skeletal site, ± regional lymph node involvement
              • Multiple bone involvement, without visceral or lymph node involvement
                • Termed primary multifocal osseous lymphoma
                • Diagnosis requires absence of involvement of distant lymph nodes or viscera for 6 months following diagnosis
                • More frequent in children than adults
            • Secondary lymphoma of bone
              • Presentation with bone tumor, but work-up shows involvement of viscera or lymph nodes in multiple regions
              • Known soft tissue lymphoma, with bone biopsy demonstrating involvement of bone

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Nuclear Medicine Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Messina C et al: Primary and secondary bone lymphomas. Cancer Treat Rev. 41(3):235-246, 2015
                                      2. Liu YC et al: Prognostic factors and treatment efficacy in patients with primary diffuse large B-cell lymphoma of the bone: single institute experience over 11 years. Intern Med. 53(2):95-101, 2014
                                      3. Wu H et al: Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas. BMC Cancer. 14:900, 2014
                                      4. Wu H et al: Prognostic significance of soft tissue extension, international prognostic index, and multifocality in primary bone lymphoma: a single institutional experience. Br J Haematol. 166(1):60-8, 2014
                                      5. Demircay E et al: Malignant lymphoma of bone: a review of 119 patients. Clin Orthop Relat Res. 471(8):2684-90, 2013
                                      6. Lim CY et al: Imaging of musculoskeletal lymphoma. Cancer Imaging. 13(4):448-57, 2013
                                      7. Thomas AG et al. Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol. 2011 Aug;197(2):357-64, 2011
                                      8. Chua SC et al: Imaging features of primary extranodal lymphomas. Clin Radiol. 64(6):574-88, 2009
                                      9. Catlett JP et al: Primary lymphoma of bone: an institutional experience. Leuk Lymphoma. 49(11):2125-32, 2008
                                      10. Power DG et al: Primary bone lymphoma: single institution case series. Ir J Med Sci. 177(3):247-51, 2008
                                      11. Sato TS et al: Primary multifocal osseous lymphoma in a child. Pediatr Radiol. 38(12):1338-41, 2008
                                      12. Ford DR et al: Primary bone lymphoma--treatment and outcome. Clin Oncol (R Coll Radiol). 19(1):50-5, 2007
                                      13. Heyning FH et al: MR imaging characteristics in primary lymphoma of bone with emphasis on non-aggressive appearance. Skeletal Radiol. 36(10):937-44, 2007
                                      14. Horsman JM et al: Primary bone lymphoma: a retrospective analysis. Int J Oncol. 28(6):1571-5, 2006
                                      15. Mengiardi B et al: Primary lymphoma of bone: MRI and CT characteristics during and after successful treatment. AJR Am J Roentgenol. 184(1):185-92, 2005
                                      16. Krishnan A et al: Primary bone lymphoma: radiographic-MR imaging correlation. Radiographics. 23(6):1371-83; discussion 1384-7, 2003
                                      17. Rahmouni A et al: Bone marrow with diffuse tumor infiltration in patients with lymphoproliferative diseases: dynamic gadolinium-enhanced MR imaging. Radiology. 229(3):710-7, 2003
                                      18. Unni KK et al. Malignant lymphoma. In Fletcher CDM et al: World Health Organization Classification of Tumors: Tumors of Soft Tissue and Bone. Lyon: IARC Press. 306-8, 2002
                                      19. Mulligan ME et al: Imaging features of primary lymphoma of bone. AJR Am J Roentgenol. 173(6):1691-7, 1999
                                      20. Melamed JW et al: Imaging of primary multifocal osseous lymphoma. Skeletal Radiol. 26(1):35-41, 1997
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Primary lymphoma of bone (PLB)
                                            • Synonyms

                                              • Reticulum cell sarcoma, primary non-Hodgkin lymphoma of bone, primary lymphoma of bone, osteolymphoma, lymphosarcoma
                                            • Definitions

                                              • Neoplasm composed of malignant lymphoid cells
                                              • Divided into 1° or 2° lymphoma of bone
                                                • PLB
                                                  • Single skeletal site, ± regional lymph node involvement
                                                  • Multiple bone involvement, without visceral or lymph node involvement
                                                    • Termed primary multifocal osseous lymphoma
                                                    • Diagnosis requires absence of involvement of distant lymph nodes or viscera for 6 months following diagnosis
                                                    • More frequent in children than adults
                                                • Secondary lymphoma of bone
                                                  • Presentation with bone tumor, but work-up shows involvement of viscera or lymph nodes in multiple regions
                                                  • Known soft tissue lymphoma, with bone biopsy demonstrating involvement of bone

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Nuclear Medicine Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Messina C et al: Primary and secondary bone lymphomas. Cancer Treat Rev. 41(3):235-246, 2015
                                                                          2. Liu YC et al: Prognostic factors and treatment efficacy in patients with primary diffuse large B-cell lymphoma of the bone: single institute experience over 11 years. Intern Med. 53(2):95-101, 2014
                                                                          3. Wu H et al: Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas. BMC Cancer. 14:900, 2014
                                                                          4. Wu H et al: Prognostic significance of soft tissue extension, international prognostic index, and multifocality in primary bone lymphoma: a single institutional experience. Br J Haematol. 166(1):60-8, 2014
                                                                          5. Demircay E et al: Malignant lymphoma of bone: a review of 119 patients. Clin Orthop Relat Res. 471(8):2684-90, 2013
                                                                          6. Lim CY et al: Imaging of musculoskeletal lymphoma. Cancer Imaging. 13(4):448-57, 2013
                                                                          7. Thomas AG et al. Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol. 2011 Aug;197(2):357-64, 2011
                                                                          8. Chua SC et al: Imaging features of primary extranodal lymphomas. Clin Radiol. 64(6):574-88, 2009
                                                                          9. Catlett JP et al: Primary lymphoma of bone: an institutional experience. Leuk Lymphoma. 49(11):2125-32, 2008
                                                                          10. Power DG et al: Primary bone lymphoma: single institution case series. Ir J Med Sci. 177(3):247-51, 2008
                                                                          11. Sato TS et al: Primary multifocal osseous lymphoma in a child. Pediatr Radiol. 38(12):1338-41, 2008
                                                                          12. Ford DR et al: Primary bone lymphoma--treatment and outcome. Clin Oncol (R Coll Radiol). 19(1):50-5, 2007
                                                                          13. Heyning FH et al: MR imaging characteristics in primary lymphoma of bone with emphasis on non-aggressive appearance. Skeletal Radiol. 36(10):937-44, 2007
                                                                          14. Horsman JM et al: Primary bone lymphoma: a retrospective analysis. Int J Oncol. 28(6):1571-5, 2006
                                                                          15. Mengiardi B et al: Primary lymphoma of bone: MRI and CT characteristics during and after successful treatment. AJR Am J Roentgenol. 184(1):185-92, 2005
                                                                          16. Krishnan A et al: Primary bone lymphoma: radiographic-MR imaging correlation. Radiographics. 23(6):1371-83; discussion 1384-7, 2003
                                                                          17. Rahmouni A et al: Bone marrow with diffuse tumor infiltration in patients with lymphoproliferative diseases: dynamic gadolinium-enhanced MR imaging. Radiology. 229(3):710-7, 2003
                                                                          18. Unni KK et al. Malignant lymphoma. In Fletcher CDM et al: World Health Organization Classification of Tumors: Tumors of Soft Tissue and Bone. Lyon: IARC Press. 306-8, 2002
                                                                          19. Mulligan ME et al: Imaging features of primary lymphoma of bone. AJR Am J Roentgenol. 173(6):1691-7, 1999
                                                                          20. Melamed JW et al: Imaging of primary multifocal osseous lymphoma. Skeletal Radiol. 26(1):35-41, 1997