primäres Lymphom des Knochens

Imaging of
skull vault tumors in adults. Lymphoma. Case 1 (a–d): NECT (a, b), post-contrast T1WI (c), and ADC map (d). Transdiploic mass with bone subtle sclerosis (arrows) and disproportionate soft-tissue components dense on CT, homogenously enhancing, and diffusion-restricting (arrowheads). Case 2 (e–g): Similar findings with bone lytic-permeation (arrows) instead
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An unusual
cause of bone lesions in paediatric age. Multiple areas low/intermediate signal in the distal femoral metadiaphysis. Cortical circumferencial thickening and lamellated periosteal reaction is also evident (arrows). Note the peri-tumoral oedema (stars) without evidence of soft-tissue mass.
www.eurorad.org • CC by-nc-sa-4.0
An unusual
cause of bone lesions in paediatric age. Multiple areas of bone marrow replacement in the distal femoral metadiaphysis (low signal areas), with physeal extension (asterisk). Cortical circumferencial thickening and lamellated periosteal reaction (arrows) is also present.
www.eurorad.org • CC by-nc-sa-4.0
An unusual
cause of bone lesions in paediatric age. Frontal (a) and lateral (b) radiographs show lytic permeative changes in the distal metadiaphysis of the right femur with a lamellated periosteal reaction (arrows).
www.eurorad.org • CC by-nc-sa-4.0
Spectrum of
lytic lesions of the skull: a pictorial essay. Primary lymphoma of the bone, same patient shown in Fig. 11. On MRI, the lesion demonstrates low T2 signal on axial (a) and coronal (b) T2-weighted sequences and extension to the temporal fossa and to the epidural space of the middle cranial fossa. The tumour exhibits homogeneous contrast enhancement; axial T1-weighted before (c) and after (d) contrast administration
insightsimaging.springeropen.com • CC-by-4.0
Spectrum of
lytic lesions of the skull: a pictorial essay. Primary lymphoma of the bone. Axial CT images with soft tissues (a) and bone (b) windows highlight the presence of a bone lesion of the squamous portion of the left temporal bone, with lytic permeative pattern, extending to temporal extracranial soft tissues
insightsimaging.springeropen.com • CC-by-4.0
Primary bone
lymphoma of the left radius: a case report and related literature review. X-ray radiograph showed a large osteolytic lesion of the distal region of the left radius.
eurjmedres.biomedcentral.com • CC-by-2.0
Primary
diffuse large B-cell lymphoma of the bone: bendamustine and rituximab are able to overcome resistant disease. PET image after second (Panel A), third (Panel B) and fourth relapse (Panel C) as well as after BR treatment (Panel D).
springerplus.springeropen.com • CC-by-4.0
Primary
diffuse large B-cell lymphoma of the bone: bendamustine and rituximab are able to overcome resistant disease. Computed tomography (CT) and Positron emission tomography (PET) images at the time of diagnosis. Panel A: CT scan showing the pathological tissue of the mid-diaphysis of the left humerus infiltrating the adjacent biceps brachii muscle for a longitudinal extent of 10.5 cm and axial dimensions of up to 5.5 cm. Several lymph nodes placed in the supraclavicular (1 cm), subclavian (2 cm) and in the axilla (19 mm). Panel B: PET image at the diagnosis with FDG uptake restricted to the primary mass, sparing locoregional lymph nodes.
springerplus.springeropen.com • CC-by-4.0
Primary bone
lymphoma of the mandible and thyroid incidentaloma identified by 18FDG PET/CT: a case report. 18FDG PET/CT showing the left mandible lesion in sagital (a) , coronal (b) and axial (d) view. Image (c) shows an osteolytic lesion in the left mandible in an axial view of the CT scan.
casesjournal.biomedcentral.com • CC-by-2.0
An unusual
cause of bone lesions in paediatric age. Fat-suppressed T1 weighted images before (a) and after (b) administration of contrast material shows areas of enhancement within the intramedullary lesion, without evidence of soft-tissue mass.
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Primary bone (skeletal/osseous) lymphoma (PBL) is a less common manifestation of lymphoma than secondary involvement from disseminated lymphoma. It is rare, accounting for <5% of bone tumors and <1% of non-Hodgkin lymphoma.

Terminology

PBL is defined as the presence of lymphoma isolated to one bone without distant spread for six months after diagnosis. Multifocal PBL is less common and occurs with lymphoma is confined to two or more bones, again without distant spread for six months .

Epidemiology

PBL can affect any age group, with peak incidence in (50-60) year-olds. It is rare in children <10 years old. There is a slight male predominance (M:F = 1.5:1) .

Clinical presentation

Symptoms include localized pain and swelling, B-type symptoms, pathological fractures, and cord compression.

Pathology

Diffuse large B cell lymphoma (DLBCL) is the most common subtype. The bony pelvis and femur are the most common locations .

Radiographic features

Plain radiograph

PBL has non-specific features and the affected bone may be normal or affected by lytic, sclerotic or mixed pattern. The most common is a lytic pattern with permeative bone destruction and a wide zone of transition .

MRI

Associated soft tissue masses are common. Bone marrow changes include :

  • T1: low signal
  • T2: high signal

Treatment and prognosis

Five-year survival rate has been reported at ~ 80%, much better than other bone tumors .

Differential diagnosis

For plain film presentation of permeative bone destruction consider :

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu primäres Lymphom des Knochens:
sekundärer
Knochenbefall bei Lymphom
Wikipedia • CC BY-SA 3.0
primäres
Lymphom des Schädelknochens
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