Primary bone lymphoma: A case report and review of the literature

Zhou,Hai‑Yan; Gao,Fang; Bu,Bing; Fu,Zheng; Sun,Xu‑Jie; Huang,Cheng‑Suo; Zhou,Deng‑Guang; Zhang,Shu; Xiao,Jun

doi:10.3892/ol.2014.2327

Primary bone lymphoma: A case report and review of the literature

Authors:
- Hai‑Yan Zhou
- Fang Gao
- Bing Bu
- Zheng Fu
- Xu‑Jie Sun
- Cheng‑Suo Huang
- Deng‑Guang Zhou
- Shu Zhang
- Jun Xiao
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Affiliations: Internal Depatment of Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China, Positron Emission Tomography‑Computed Tomography Center, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China, Department of Pathology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China
Published online on: July 9, 2014 https://doi.org/10.3892/ol.2014.2327
Pages: 1551-1556

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Abstract

Primary lymphoma of the bone (PLB) primarily arising from the medullary cavity is an extremely rare entity, with only retrospective studies and sporadic cases reported in the literature. The current study presents one case of PLB treated with chemotherapy and radiotherapy, and a review of the literature to elucidate the optimal treatment of PLB. A 73‑year‑old female presented with pain in the left hip that had persisted for two months. Plain X‑ray and magnetic resonance imaging of the left hip showed lytic areas involving the left innominatum. Technetium‑99m radionuclide imaging showed increased tracer uptake in the ilium, acetabulum and ischium. An 18F‑fluorodeoxyglucose‑positron emission tomography‑computed tomography (FDG‑PET‑CT) scan showed high FDG uptake. A fine‑needle aspiration biopsy of the lesion was performed, and histopathological and immunohistochemical examination confirmed a diagnosis of B‑cell lymphoma. The patient received radiation therapy followed by six cycles of CHOP regimen (1,000 mg cyclophosphamide, 80 mg epirubicine and 2 mg vincristine on day one, and 100 mg prednisone on days one to five, every three weeks) and achieved a complete response, as confirmed by FDG‑PET‑CT. At present, the patient is in a good condition. This case is noteworthy, as it is a well‑documented case in which the patient received successful treatment. This case demonstrates that PLB has an improved prognosis compared with primary lymphoma of other sites; however, combined therapy may further improve the patient outcome.

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1	Singh T, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu GK, Lokanatha D, Jacob LA and Halkud R: Primary bone lymphoma: a report of two cases and review of the literature. J Cancer Res Ther. 6:296–298. 2010.
2	Oberling C: The reticulosarcomas and the reticulotheliomas of Ewing’s osterosarcoma. Bull Assoc Fr Etude Cancer (Paris). 17:259–296. 1928.(In French).
3	Heyning FH, Hogendoorn PC, Kramer MH, Hermans J, Kluin-Nelemans JC, Noordijk EM and Kluin PM: Primary non-Hodgkin’s lymphoma of bone: a clinicopathological investigation of 60 cases. Leukemia. 13:2094–2098. 1999.
4	Lewis VO, Primus G, Anastasi J, Doherty D, Montag AG, Peabody TD and Simon MA: Oncologic outcomes of primary lymphoma of bone in adults. Clin Orthop Relat Res. 415:90–97. 2003.
5	Jawad MU, Schneiderbauer MM, Min ES, Cheung MC, Koniaris LG and Scully SP: Primary lymphoma of bone in adult patients. Cancer. 116:871–879. 2010.
6	Mulligan ME, McRae GA and Murphey MD: Imaging features of primary lymphoma of bone. AJR Am J Roentgenol. 173:1691–1697. 1999.
7	Song YG, Hahn JS, Choi YH, Yeom JS, Yang WI, Seo CO and Kim JM: A case of primary bone lymphoma associated with acquired immunodeficiency syndrome. Yonsei Med J. 39:383–389. 1998.
8	Bao J: Young males with primary lymphoma of bone presenting with musculoskeletal pain are prone to be misdiagnosed as ankylosing spondylitis: a case report. Rheumatol Int. 32:263–264. 2012.
9	ter Braak BP, Guit GL and Bloem JL: Case 111: Soft-tissue lymphoma. Radiology. 243:293–296. 2007.
10	O’Neill J, Finlay K, Jurriaans E and Friedman L: Radiological manifestations of skeletal lymphoma. Curr Probl Diagn Radiol. 38:228–236. 2009.
11	Heyning FH, Hogendoorn PC, Kramer MH, Holland CT, Dreef E and Jansen PM: Primary lymphoma of bone: extranodal lymphoma with favourable survival independent of germinal centre, post-germinal centre or indeterminate phenotype. J Clin Pathol. 62:820–824. 2009.
12	Catlett JP, Williams SA, O’Connor SC, Krishnan J and Malkovska V: Primary lymphoma of bone: an institutional experience. Leuk Lymphoma. 49:2125–2132. 2008.
13	O’Connor AR, Birchall JD, O’Connor SR and Bessell E: The value of 99mTc-MDP bone scintigraphy in staging primary lymphoma of bone. Nucl Med Commun. 28:529–531. 2007.
14	Park YH, Choi SJ, Ryoo BY and Kim HT: PET imaging with F-18 fluorodeoxyglucose for primary lymphoma of bone. Clin Nucl Med. 30:131–134. 2005.
15	Kitsoulis P, Vlychou M, Papoudou-Bai A, Karatzias G, Charchanti A, Agnantis NJ and Bai M: Primary lymphomas of bone. Anticancer Res. 26:325–337. 2006.
16	Park YH, Kim S, Choi SJ, Ryoo BY, Yang SH, Cheon GJ, Choi CW, Lim SM, Yoo JY and Lee SS: Clinical impact of whole-body FDG-PET for evaluation of response and therapeutic decision-making of primary lymphoma of bone. Ann Oncol. 16:1401–1402. 2005.
17	Yuste AL, Segura A, López-Tendero P, Gironés R, Montalar J and Gómez-Codina J: Primary lymphoma of bone: a clinico-pathological review and analysis of prognostic factors. Leuk Lymphoma. 45:853–855. 2004.
18	Stein ME, Kuten A, Gez E, Rosenblatt KE, Drumea K, Ben-Shachar M, Zidan J, Haim N and Epelbaum R: Primary lymphoma of bone - a retrospective study. Experience at the Northern Israel Oncology Center (1979–2000). Oncology. 64:322–327. 2003.
19	Amara H, Elomri H, Cherni N, Tlili K, Mrad-Dali K, Sriha B, Kraiem C and Nabli S: Primary lymphoma of bone: imaging features. J Radiol. 83:55–58. 2002.(In French).
20	Huebner-Chan D, Fernandes B, Yang G and Lim MS: An immunophenotypic and molecular study of primary large B-cell lymphoma of bone. Mod Pathol. 14:1000–1007. 2001.
21	Marshall DT, Amdur RJ, Scarborough MT, Mendenhall NP and Virkus WW: Stage IE primary non-Hodgkin’s lymphoma of bone. Clin Orthop Relat Res. 405:216–222. 2002.
22	Brousse C, Baumelou E and Morel P: Primary lymphoma of bone: a prospective study of 28 cases. Joint Bone Spine. 67:446–451. 2000.
23	Evron E, Goland S, Klepfish A, Malnick SD, Sokolowski N and Sthoeger ZM: Primary multifocal lymphoma of bone presenting as hypercalcemic crisis: report of a rare manifestation of extranodal lymphoma. Leuk Lymphoma. 34:197–200. 1999.
24	Haussler MD, Fenstermacher MJ, Johnston DA and Harle TS: MRI of primary lymphoma of bone: cortical disorder as a criterion for differential diagnosis. J Magn Reson Imaging. 9:93–100. 1999.
25	White LM, Schweitzer ME, Khalili K, Howarth DJ, Wunder JS and Bell RS: MR imaging of primary lymphoma of bone: variability of T2-weighted signal intensity. AJR Am J Roentgenol. 170:1243–1247. 1998.
26	Niitsu N, Nakayama M and Umeda M: A clinical study of primary lymphoma of bone. Rinsho Ketsueki. 39:432–435. 1998.(In Japanese).
27	Ramadan KM, Shenkier T, Sehn LH, Gascoyne RD and 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. 18:129–135. 2007.
28	Power DG, McVey GP, Korpanty G, et al: Primary bone lymphoma: single institution case series. Ir J Med Sci. 177:247–251. 2008.
29	Freeman C, Berg JW and Cutler SJ: Occurrence and prognosis of extranodal lymphomas. Cancer. 29:252–260. 1972.
30	Rudders RA, Ross ME and DeLellis RA: Primary extranodal lymphoma: response to treatment and factors influencing prognosis. Cancer. 42:406–416. 1978.
31	Barbieri E, Cammelli S, Mauro F, et al: 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. 59:760–764. 2004.
32	Fidias P, Spiro I, Sobczak ML, et al: Long-term results of combined modality therapy in primary bone lymphomas. Int J Radiat Oncol Biol Phys. 45:1213–1218. 1999.
33	Ferreri AJ, Reni M, Ceresoli GL and Villa E: Therapeutic management with adriamycin-containing chemotherapy and radiotherapy of monostotic and polyostotic primary non-Hodgkin’s lymphoma of bone in adults. Cancer Invest. 16:554–561. 1998.
34	Shoji H and Miller TR: Primary reticulum cell sarcoma of bone. Significance of clinical features upon the prognosis. Cancer. 28:1234–1244. 1971.
35	Glotzbecker MP, Kersun LS, Choi JK, Wills BP, Schaffer AA and Dormans JP: Primary non-Hodgkin’s lymphoma of bone in children. J Bone Joint Surg Am. 88:583–594. 2006.
36	Durr HR, Müller PE, Hiller E, Maier M, Baur A, Jansson V and Refior HJ: Malignant lymphoma of bone. Arch Orthop Trauma Surg. 122:10–16. 2002.
37	Beal K, Allen L and Yahalom J: Primary bone lymphoma: treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer. 106:2652–2656. 2006.
38	Sehn LH, Donaldson J, Chhanabhai M, Fitzgerald C, Gill K, Klasa R, MacPherson N, O’Reilly S, Spinelli JJ, Sutherland J, et al: Introduction of combined CHOP plus rituximab therapy dramatically improved outcome of diffuse large B-cell lymphoma in British Columbia. J Clin Oncol. 23:5027–5033. 2005.