50 Primary Lymphoma of Bone

CASE 50

Primary Lymphoma of Bone

George Nomikos, Anthony G. Ryan, Peter L. Munk, and Mark Murphey

Clinical Presentation

A 38-year-old man presented with left hip pain.

Figure 50A

Figure 50B

Figure 50C

Figure 50D

The frog-leg view of the left hip (Fig. 50A) shows sclerosis with some intermixed areas of lucency within the left femoral head and neck. The T1-weighted image (Fig. 50B) from the MRI examination shows marrow replacement in the femoral head and neck, as well as a large soft-tissue mass. On the T2-weighted image (Fig. 50C), marrow replacement is again seen in the proximal femur. The lesion is intermediate in signal intensity on the T2-weighted image. Also note the lack of obvious cortical destruction, despite the presence of a large soft-tissue mass. The large soft-tissue component with relative preservation of the cortex is also demonstrated on the STIR image (Fig. 50D).