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.



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Figure 50A



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Figure 50B



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Figure 50C



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Figure 50D


Radiologic Findings


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).


Diagnosis


Primary lymphoma of bone.


Differential Diagnosis



  • Metastatic disease
  • Ewing’s sarcoma/primitive neuroectodermal tumors (PNETs)
  • Myeloma
  • Leukemia
  • Langerhans’ cell histiocytosis
  • Osteosarcoma
  • Malignant fibrous histiocytoma or fibrosarcoma of bone
  • Infection

Discussion


Background

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Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 50 Primary Lymphoma of Bone

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