Primary Non-Hodgkin's Lymphoma of the Bone: A case report
Keywords:Primary non-Hodgkin's lymphoma of bone, Pathological fracture, Chemotherapy
Primary non-Hodgkin's lymphoma of the bone (PLB) is a rare entity. Patients generally present with localized bone pain, soft-tissue swelling or palpable mass. Pathological fracture of the proximal femur and humerus secondary to soft-tissue tumors is well documented in the literature. Lymphomas presenting primarily at these sites with pathological fractures are unusual. A review of the literature shows that the incidence of the skeletal manifestations from non-Hodgkin's lymphoma is less than 5%, and in all these cases, bony involvement was reported many years after the presentation of the primary cancer. Histopathologically, PLB usually represents diffuse large B-cell lymphoma. We report a 56-year-old female patient with primary non-Hodgkin's lymphoma of proximal femur with pathological fracture and management. In January 2014, a 56-year-old woman was diagnosed with stage IV B primary large-cell diffuse primary non-Hodgkin’s lymphoma. After one year of initial diagnostic procedures and chemotherapy with rituximab together with cyclophosphamide, vincristine, procarbazine, and prednisolone she achieved a complete response.
2. Barbieri E, Cammelli S, Mauro F, Perini F, Cazzola A, Neri S, Bunkheila F, Ferrari S, Brandoli V, Zinzani P, Mercuri M, Bacci G. Primary non-Hodgkin's lymphoma of the bone: treatment and analysis of prognostic factors for Stage I and Stage II. Int J Radiat Oncol Biol Phys. 2004;59(3):760-764. doi: 10.1016/j.ijrobp.2003.11.020.
3. Durr HR, Muller PE, Hiller E, Maier M, Baur A, Jansson V, Refior HJ. Malignant lymphoma of bone. Arch Orthop Trauma Surg. 2002;122(1):10-16.
4. Glotzbecker MP, Kersun LS, Choi JK, Wills BP, Schaffer AA, Dormans JP. Primary non-Hodgkin's lymphoma of bone in children. J Bone Joint Surg Am. 2006;88(3):583-594. doi: 10.2106/jbjs.d.01967.
5. Hsieh PP, Tseng HH, Chang ST, Fu TY, Lu CL, Chuang SS. Primary non-Hodgkin's lymphoma of bone: a rare disorder with high frequency of T-cell phenotype in southern Taiwan. Leuk Lymphoma. 2006;47(1):65-70. doi: 10.1080/10428190500272705.
6. Krishnan A, Shirkhoda A, Tehranzadeh J, Armin AR, Irwin R, Les K. Primary bone lymphoma: radiographic-MR imaging correlation. Radiographics. 2003;23(6):1371-1383; discussion 1384-1377. doi: 10.1148/rg.236025056.
7. Rappaport DC, Chamberlain DW, Shepherd FA, Hutcheon MA. Lymphoproliferative disorders after lung transplantation: imaging features. Radiology. 1998;206(2):519-524. doi: 10.1148/radiology.206.2.9457207.
8. Stein ME, Kuten A, Gez E, Rosenblatt KE, Drumea K, Ben-Shachar M, Zidan J, Haim N, Epelbaum R. Primary lymphoma of bone--a retrospective study. Experience at the Northern Israel Oncology Center (1979-2000). Oncology. 2003;64(4):322-327. doi: 70288.
9. Ramadan KM, Shenkier T, Sehn LH, Gascoyne RD, Connors JM. A clinicopathological retrospective study of 131 patients with primary bone lymphoma: a population-based study of successively treated cohorts from the British Columbia Cancer Agency. Ann Oncol. 2007;18(1):129-135. doi: 10.1093/annonc/mdl329.
10. Singh T, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu GK, Lokanatha D, Jacob LA, Halkud R. Primary bone lymphoma: a report of two cases and review of the literature. J Cancer Res Ther. 2010;6(3):296-298. doi: 10.4103/0973-1482.73366.
11. Rojas N, Fernandes C, Conde M, Montala N, Fornos X, Rossello L, Palliso F. Non-Hodgkin's lymphoma and atypical neck pain: A case report. Reumatol Clin. 2017. doi: 10.1016/j.reuma.2017.03.018.
12. Wang J, Fan S, Liu J, Song B. A rare case report of primary bone lymphoma and a brief review of the literature. Onco Targets Ther. 2016;9:4923-4928. doi: 10.2147/ott.s108000.
13. Lima FP, Bousquet M, Gomez-Brouchet A, de Paiva GR, Amstalden EM, Soares FA, Dastugue N, Vassallo J, Brousset P. Primary diffuse large B-cell lymphoma of bone displays preferential rearrangements of the c-MYC or BCL2 gene. Am J Clin Pathol. 2008;129(5):723-726. doi: 10.1309/cmpgpytmfrm6rvqr.
14. Power DG, McVey GP, Korpanty G, Treacy A, Dervan P, O'Keane C, Carney DN. Primary bone lymphoma: single institution case series. Ir J Med Sci. 2008;177(3):247-251. doi: 10.1007/s11845-008-0165-8.
15. Chisholm KM, Ohgami RS, Tan B, Hasserjian RP, Weinberg OK. Primary lymphoma of bone in the pediatric and young adult population. Hum Pathol. 2017;60:1-10. doi: 10.1016/j.humpath.2016.07.028.
16. Salter M, Sollaccio RJ, Bernreuter WK, Weppelmann B. Primary lymphoma of bone: the use of MRI in pretreatment evaluation. Am J Clin Oncol. 1989;12(2):101-105.
17. Peng X, Wan Y, Chen Y, Chen L, He A, Liao W, Shen J, Fu Q, Han S, Li F, Zou X. Primary non-Hodgkin's lymphoma of the spine with neurologic compression treated by radiotherapy and chemotherapy alone or combined with surgical decompression. Oncol Rep. 2009;21(5):1269-1275.
18. Siddiqui YS, Khan AQ, Sherwani M. Pathological Fractures in Primary Non-Hodgkin's Lymphoma of the Bone: A Case Series with Review of the Literature. J Clin Diagn Res. 2013;7(3):513-517. doi: 10.7860/jcdr/2013/3948.2809.
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