Primary bone lymphoma
Primary bone (skeletal/osseous) lymphoma (PBL) is a less common manifestation than secondary involvement from disseminated lymphoma. It is a rare, accounting for <5% of bone tumors and <1% of non-Hodgkin lymphoma.
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 1.
PBL can affect any age group, with peak incidence in 50-to-60 year olds. It is rare in children <10 years old. There is a slightly male predominance (M:F = 1.5:1) 2.
PBL has non-specific features and may be normal, lytic, sclerotic or mixed. The common pattern is a lytic pattern with permeative bone destruction with a wide zone of transition 1.
Associated soft tissue masses are common. Bone marrow changes include 2:
- T1: low signal
- T2: high signal
Treatment and prognosis
Five-year survival rate has been reported at ~80%, much better than other bone tumors 2.
For plain film presentation of permeative bone destruction consider 1: