Primary bone lymphoma: report of an unusual case with a review of the literature

Diagnosis of skeletal lymphoma and myeloma by radiology and fine needle aspiration cytology

Diagnosis of skeletal lymphoma and myeloma by radiology and fine needle aspiration cytology From 1986 to 1998, all patients referred to Karolinska Hospital because of a skeletal destruction of unknown origin routinely underwent radiographic examination and fine needle aspiration cytology (FNAC). Among these, there were 83 patients with solitary lesions of the bone diagnosed and treated for myeloma (plasmacytoma) or non-Hodgkin's lymphoma. Review of the series showed that myeloma could not be distinguished radiographically from lymphoma. Nor could low and high grade lymphoma lesions be discriminated by radiographic appearance. The diagnostic utility of plain radiography in the two conditions seems to be confined to the mere detection of a destructive bone lesion and visual guidance for FNAC. The latter aspect, however, is crucial for the application of FNAC to bone lesions. Review of the cytologic specimens obtained by FNAC showed that they allowed a conclusive diagnosis in all 40 myeloma cases and in 41 of 43 lymphoma cases. In 32 of the 40 myeloma cases, the FNAC material could be used for immunocytochemistry, which disclosed kappa or lambda light chain restriction, corroborating the cytomorphological diagnosis. Thirty-eight lymphomas were characterized immunologically and in 35, a light chain restriction could be demonstrated. Our results show that the use of FNAC in the diagnosis of primary myeloma and lymphoma of bone obviates the need for other diagnostic modalities, including open biopsy. A combined approach based on radiology and FNAC, performed as an out-patient procedure, offers rapid and accurate diagnosis of myeloma and lymphoma among patients with radiographically unclassified destructive bone lesions.

Diagnosis of anaplastic large-cell lymphoma, including multifocal osseous KI-1 lymphoma, by fine-needle aspiration biopsy

We present the fine-needle aspiration (FNA) findings of 4 cases of anaplastic (Ki-1) large-cell lymphoma (ALCL). A primary diagnosis of ALCL was made on FNA material in 2 cases, of which one was a multifocal osseous Ki-1 lymphoma. In the other 2 patients who had a known history of ALCL, FNA was used to detect recurrent disease. In all cases, large discohesive pleomorphic cells in the absence of lymphoglandular bodies in the background raised the possibility of a nonhematopoietic neoplasm. Immunochemical staining for CD30 was positive in all cases. The cytomorphologic and immunochemical features are discussed, along with the differential diagnosis of Ki-1 lymphoma. Diagn. Cytopathol. 1999;21:174-179.

Lymphoma at uncommon sites

Lymphoma can often present in unusual situations. This article provides a comprehensive review of the literature in which both non-Hodgkin's lymphoma and Hodgkin's disease are discussed.