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Panagopoulos A, Solou K, Symeonidis A, Verigou E, Kouroukli O, Zolota V, Kokkalis ZT. Delayed diagnosis of a primary diffuse large B-cell lymphoma of the humeral head, presenting as pathological fracture: a case report and review of the literature. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:299-311. [PMID: 38706663 PMCID: PMC11065756 DOI: 10.1016/j.xrrt.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Andreas Panagopoulos
- Department of Orthopaedics, University Hospital of Patras, Medical School, Patras, Greece
| | - Konstantina Solou
- Department of Orthopaedics, University Hospital of Patras, Medical School, Patras, Greece
| | - Argiris Symeonidis
- Hematology Division, Department of Internal Medicine, University Hospital of Patras, Medical School, Patras, Greece
| | - Evgenia Verigou
- Hematology Division, Department of Internal Medicine, University Hospital of Patras, Medical School, Patras, Greece
| | - Olga Kouroukli
- Department of Pathology, University Hospital of Patras, Medical School, Patras, Greece
| | - Vasiliki Zolota
- Department of Pathology, University Hospital of Patras, Medical School, Patras, Greece
| | - Zinon T. Kokkalis
- Department of Orthopaedics, University Hospital of Patras, Medical School, Patras, Greece
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Role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and treatment response assessment of primary bone lymphoma. Nucl Med Commun 2023; 44:318-329. [PMID: 36722755 PMCID: PMC9994810 DOI: 10.1097/mnm.0000000000001668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Primary bone lymphoma (PBL) is a rare type of extranodal lymphoma, and the clinical application value of 18F-fluorodeoxyglucose PET/computed tomography ( 18 F-FDG PET/CT) in PBL has not been fully evaluated. This study aimed to determine the imaging characteristics of PBL and investigate the value of 18 F-FDG PET/CT parameters. METHODS A total of 25 patients with PBL who underwent PET/CT examination before treatment were included in this study. The clinicopathological parameters and PET/CT parameters were analyzed. RESULTS Among the 25 patients, 7 patients had single lesions, 15 patients had nonsingle lesions (≥2) and 3 patients had diffuse distribution in the medullary cavity. The bone destruction types included osteolytic, osteogenic, normal density, mixed lytic and osteogenic. All patients showed increased FDG uptake, and the CT detection rate was 88%. Five patients underwent PET/CT assessment mid-treatment, and when assessed using the Deauville five-point scale, four patients were PET-negative and one patient was PET-positive. There were two PET-positive and three PET-negative patients when assessed using the Δ maximum standardized uptake value (SUV max ) method. Six patients underwent PET/CT imaging at the end of treatment. When assessed using the Deauville five-point scale, five patients (83%) were PET-negative and one patient (17%) was PET-positive. The same results were obtained when evaluated by the ΔSUV max method. CONCLUSION PET/CT plays a substantial role in the diagnosis and treatment efficacy evaluation of PBL, and it should be recognized by clinicians and radiologists. Changes in metabolic parameters such as SUV, metabolic tumor volume and total lesion glycolysis have considerable potential for application in PBL diagnostics and treatment efficacy evaluation.
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Bhakta P, Hunzeker ZE, Garcia JD, Youssef A, Grant BJ, Alfattal R, Weaver D, Bhargava P, Rischall A, Musunuru T, Muthukumarana PV, Mallick J, Lyapichev KA. Pathological fracture due to primary bone lymphoma in a patient with a history of prostate cancer: A case report and review of literature. Front Oncol 2023; 13:1100559. [PMID: 37007154 PMCID: PMC10061010 DOI: 10.3389/fonc.2023.1100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
Primary bone lymphoma (PBL) is a rare extranodal presentation within lymphomas and primary bone malignancies. Pathologic fracture (PF) is a common complication of metastatic bone disease but is, rarely, the presentation of a primary bone tumor. We report a case of an 83-year-old man with a history of untreated prostate cancer, presenting with atraumatic fracture of his left femur after months of intermittent pains and weight loss. Radiographic workup revealed a lytic lesion suspicious for PF secondary to metastatic prostate cancer; however, initial core biopsy results were inconclusive for malignancy. A complete blood count with differential and complete metabolic panel was within normal limits. During surgical fixation and nailing of the femur, a reaming biopsy was performed as a repeat measure and revealed diffuse large B-cell lymphoma. Staging with positron emission tomography and computed tomography found no evidence of lymphatic or visceral involvement and chemotherapy was promptly initiated. This case highlights the diagnostic workup challenges for PF secondary to PBL, especially in the setting of concurrent malignancy. Because of the non-specific presentation of a lytic lesion on imaging associated with atraumatic fracture, we highlight PBL as an important diagnostic consideration.
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Affiliation(s)
- Pooja Bhakta
- Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Zachary E. Hunzeker
- John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Juan D. Garcia
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ayman Youssef
- John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Bradley J. Grant
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Rasha Alfattal
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Dylan Weaver
- Department of Radiology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Peeyush Bhargava
- Department of Radiology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ariel Rischall
- Division of Hematology and Oncology, Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Tejo Musunuru
- Division of Hematology and Oncology, Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Palawinnage V. Muthukumarana
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Jayati Mallick
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Kirill A. Lyapichev
- Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States
- *Correspondence: Kirill A. Lyapichev,
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Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis. Diseases 2023; 11:diseases11010042. [PMID: 36975591 PMCID: PMC10047712 DOI: 10.3390/diseases11010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Primary bone lymphoma (PBL) is a rare neoplasm of malignant lymphoid cells presenting with one or more bone lesions without nodal or other extranodal involvement. It accounts for approximately 1% of all lymphomas and 7% of malignant primary bone tumors. Diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) represents the predominant histological type and constitutes over 80% of all cases. PBL may occur at all ages with a typical diagnosis age of 45–60 years and a slight male predominance. Local bone pain, soft tissue edema, palpable mass and pathological fracture are the most common clinical features. Diagnosis of the disease, which is frequently delayed due to its non-specific clinical presentation, is based on the combination of clinical examination and imaging studies and confirmed by combined histopathological and immunohistochemical examination. PBL can develop in any part of the skeleton, although it occurs most commonly in the femur, humerus, tibia, spine and pelvis. The imaging appearance of PBL is highly variable and unspecific. In terms of the cell-of-origin, most cases of primary bone DLBCL (PB-DLBCL), NOS belong to the germinal center B-cell-like subtype and specifically originate from germinal center centrocytes. PB-DLBCL, NOS has been considered a distinct clinical entity based on its particular prognosis, histogenesis, gene expression and mutational profile and miRNA signature. PBL carries a favorable prognosis, especially when treated with combined chemoradiotherapy.
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Padwal J, Baratto L, Chakraborty A, Hawk K, Spunt S, Avedian R, Daldrup-Link HE. PET/MR of pediatric bone tumors: what the radiologist needs to know. Skeletal Radiol 2023; 52:315-328. [PMID: 35804163 PMCID: PMC9826799 DOI: 10.1007/s00256-022-04113-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/11/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023]
Abstract
Integrated 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) positron emission tomography (PET)/magnetic resonance (MR) imaging can provide "one stop" local tumor and whole-body staging in one session, thereby streamlining imaging evaluations and avoiding duplicate anesthesia in young children. 18F-FDG PET/MR scans have the benefit of lower radiation, superior soft tissue contrast, and increased patient convenience compared to 18F-FDG PET/computerized tomography scans. This article reviews the 18F-FDG PET/MR imaging technique, reporting requirements, and imaging characteristics of the most common pediatric bone tumors, including osteosarcoma, Ewing sarcoma, primary bone lymphoma, bone and bone marrow metastases, and Langerhans cell histiocytosis.
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Affiliation(s)
- Jennifer Padwal
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Lucia Baratto
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Amit Chakraborty
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Kristina Hawk
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Sheri Spunt
- Department of Pediatrics, Stanford University, 725 Welch Rd., Rm. 1665, Stanford, CA, 94305-5614, USA
| | - Raffi Avedian
- Department of Surgery, Division of Pediatric Orthopedic Surgery, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94305, USA
| | - Heike E Daldrup-Link
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA.
- Cancer Imaging Program, Stanford Cancer Institute, Stanford, USA.
- Department of Pediatrics, Stanford University, 725 Welch Rd., Rm. 1665, Stanford, CA, 94305-5614, USA.
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Otsuka Y, Nakano Y, Omura D, Hasegawa K, Otsuka F. Primary bone lymphoma presenting as fever of unknown origin. J Gen Fam Med 2022; 23:280-281. [PMID: 35800636 PMCID: PMC9249926 DOI: 10.1002/jgf2.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/06/2022] [Accepted: 01/30/2022] [Indexed: 11/14/2022] Open
Abstract
We presented a case of primary bone lymphoma (PBL) which demonstrated fever of unknown origin. Although the diagnosis of PBL is difficult, up to 11% of patients with fever of unknown origin were later diagnosed with PBL, which suggests that there may be many cases of misdiagnosis. This case study emphasizes the importance of careful diagnosis for fever of unknown origin especially when the patient has bone pain.
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Affiliation(s)
- Yuki Otsuka
- Department of General MedicineOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Yasuhiro Nakano
- Department of General MedicineOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Daisuke Omura
- Department of General MedicineOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Kou Hasegawa
- Department of General MedicineOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Fumio Otsuka
- Department of General MedicineOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
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Siddiqui DEA, Akbar HF, Sadiq H, Iftikhar N, Khan MR, Raza MR. Primary Hodgkin's Lymphoma of bone in 7-year-old- an exceptional case report of youngest child in literature. Cancer Treat Res Commun 2021; 29:100448. [PMID: 34488186 DOI: 10.1016/j.ctarc.2021.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/27/2021] [Accepted: 08/15/2021] [Indexed: 11/24/2022]
Abstract
Hodgkin lymphoma (HL) is mainly considered a nodal disease but extra nodal involvement can also be seen with variable frequency. Solitary bone involvement in HL known as Primary osseous hodgkin lymphoma (POHL) is very rare. It is defined as a lymphoma that is restricted to the bone without any simultaneous organ or lymph node involvement at the time of initial diagnosis. Primary Hodgkin lymphoma of the bone can be very challenging to diagnose because of its rarity especially in children and its variable presentation. Here we report the youngest case of POHL in a girl 7 years of age. She presented with the left leg pain and B-symptoms of fever and weight loss. Initial workup and imaging were suggestive of infection or a bone tumor. Bone biopsy of left hip joint after the multiple courses of antibiotics revealed Reed Sternberg cells in the mixed inflammatory background with CD30 and PAX-5 immunohistochemical positivity confirming classical hodgkin lymphoma, mixed cellularity type. CD99 and CD1a were negative excluding ewing sarcoma and langerhan cell Histiocytosis respectively. Absence of significant lymphadenopathy or visceromegaly on staging computerized tomography (CT) scan confirmed a very rare POHL. She received standard conventional chemotherapy with radiation. Our patient is in remission for five years after treatment.
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Affiliation(s)
| | | | - Hassan Sadiq
- Dow University of Health Science, Karachi, Pakistan
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Toyota E, Taslimi S, Alkins R. Optimal Management of Calvarial Lymphoma: A Meta-Analysis. World Neurosurg 2021; 151:e484-e494. [PMID: 33901734 DOI: 10.1016/j.wneu.2021.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Calvarial lymphoma is an exceedingly rare phenomenon; the clinical presentation and imaging pattern mimic many diseases of the central nervous system. Several treatment approaches have been undertaken with variable use of surgery plus adjuvant chemotherapy and radiation; an optimal treatment algorithm has yet to be defined. The aim of this study was to better characterize management strategies and patient outcomes. METHODS An illustrative case was presented and a meta-analysis was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE and Embase were searched for cases of calvarial lymphoma. Outcomes between patients who underwent open surgery and biopsy only were compared directly. RESULTS In an analysis from 1976 to 2019, 62 patients with a median age of 60 were included. The most common presentations were subcutaneous scalp mass (89%), headaches (26%), and focal neurological deficits (21%). Osteolytic changes on computed tomography were seen in 69% of patients with extension into either the intracranial or extracranial space in 97% of cases. Surgical excision was performed in 41 patients with a remission rate of 85% and a recurrence rate of 5%, which did not vary significantly from patients treated nonsurgically (remission in 75%, P = 0.479; recurrence in 0%, P = 1.000) CONCLUSIONS: In patients presenting with a progressively enlarging scalp mass, calvarial lymphoma should be in the differential diagnosis, as it can be effectively managed with a biopsy followed by chemotherapy and radiation. The role for open surgery may be limited.
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Affiliation(s)
- Eric Toyota
- Division of Neurosurgery, Department of Surgery, Kingston Health Sciences Centre, Queen's University, Kingston.
| | - Shervin Taslimi
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ryan Alkins
- Division of Neurosurgery, Department of Surgery, Kingston Health Sciences Centre, Queen's University, Kingston
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Tazi I, Benmoussa A, Boufarissi FZ, RajaaTissir, Lahlimi FZ. [Adult non-Hodgkin bone lymphomas]. Bull Cancer 2021; 108:424-434. [PMID: 33722379 DOI: 10.1016/j.bulcan.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 10/21/2022]
Abstract
Two forms of bone lymphomas can be distinguished: the primary bone lymphoma (PBL) and the secondary bone lymphoma (SBL). PBL is a rare disease with a good prognosis. Clinical manifestations and imaging findings are usually non-specific. Patient can present with pain, swelling of affected bone or pathologic fracture. Positron emission tomography-CT scan is a sensitive imaging modality and very useful for staging, restaging, surveillance of recurrence, and monitoring of treatment response of lymphoma. The diagnosis of PBL is often difficult and made after biopsy examination. Most patients have diffuse large B-cell lymphoma. Patients have been treated with radiotherapy, chemotherapy or combination of both. Localized disease, low IPI (International Prognostic Index) and complete remission after initial treatment were associated with a better outcome. Management of late sequelae deserves particular attention. SBL is more common than PBL; this is a disseminated lymphoma with concomitant involvement of the skeleton. We review the clinical, imaging and pathologic features of bone lymphomas; and discuss therapeutic modalities as well as prognosis of these lymphomas in the era of immunochemotherapy.
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Affiliation(s)
- Illias Tazi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc.
| | - Amine Benmoussa
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - Fatima Zahra Boufarissi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - RajaaTissir
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - Fatima Zahara Lahlimi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
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Müller A, Dreyling M, Roeder F, Baur-Melnyk A, Knösel T, Klein A, Birkenmaier C, Jansson V, Dürr HR. Primary bone lymphoma: Clinical presentation and therapeutic considerations. J Bone Oncol 2020; 25:100326. [PMID: 33083218 PMCID: PMC7554647 DOI: 10.1016/j.jbo.2020.100326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 11/26/2022] Open
Abstract
Primary lymphoma of bone is a rare entity with unspecific symptoms. Typical radiology is a large soft-tissue tumor around non-destructed bone. Treatment is based on systemic chemotherapy. Chemotherapy seems to produce a better outcome than radiotherapy alone. Positiv factors: age<60 y, solitary lesion, low LDH, favourable ECOG and IPI scores.
Background Primary lymphoma of bone (PBL) is a rare entity. Due to unspecific clinical signs and equivocal radiographs diagnosis may be delayed. This retrospective report of 109 PBL cases demonstrates typical aspects of the lesion. Treatment and prognostic factors are evaluated. Methods Retrospectively patient records were reviewed. All patients were followed for evidence of local or distant recurrence. Overall survival (OS) was used as clinical outcome. Results The median age of the 109 patients was 62.8 years. The most common symptoms were pain (76%), swelling (29%), neurologic symptoms and pathological fracture (16% each). Mean duration of symptoms was 8 months (0–197 months). 19% of patients had indolent NHL subtypes, 72% aggressive NHL subtypes and 7% cases Hodgkin disease. Cyclophosphamid, doxorubicin, vincristine and prednisone (CHOP) or CHOP plus rituximab (RCHOP) were given in 88 (81%) of patients. Radiotherapy was delivered in 67 (61%) of cases. 51 (47%) patients received both. Surgical interventions were restricted to cases with complications as fractures. The 5-year OS was 66%. The 5-year OS was 66%. In the subgroup of 78 patients with aggressive NHL subtype there was a highly significant benefit for chemotherapy or chemotherapy and radiation in comparison to no treatment or radiation alone. Raised LDH, age, IPI and ECOG performance were prognostic factors. In multivariate analysis, age and raised LDH levels only kept significance. Conclusions In our series of primary bone lymphoma, chemotherapy resulted in a better outcome than Radiotherapy alone. Long-term survival is based on the stage of the disease, favoring younger (<60 years) patients with solitary bone lesions, low level of LDH and favourable ECOG performance status and IPI scores.
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Affiliation(s)
- Annika Müller
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany
| | - Martin Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Germany
| | - Falk Roeder
- Department of Radiation Oncology, Paracelsus Medizinische Privatuniversität, Landeskrankenhaus, Salzburg, Austria.,CCU Molecular Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Thomas Knösel
- Institute of Institute of Pathology, University Hospital, LMU Munich, Germany
| | - Alexander Klein
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany
| | - Christof Birkenmaier
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany
| | - Volkmar Jansson
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany
| | - Hans Roland Dürr
- Musculoskeletal Oncology, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany
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11
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Li L, Liu G, Zhu L, Li T. Primary bone lymphoma of the thoracic vertebra in a patient with metastatic lung cancer. Clin Imaging 2020; 64:119-123. [PMID: 32438255 DOI: 10.1016/j.clinimag.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/28/2020] [Accepted: 04/07/2020] [Indexed: 01/20/2023]
Abstract
We present a rare case of primary diffuse large B-cell lymphoma of the thoracic vertebra in a patient with metastatic lung cancer.
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Affiliation(s)
- Lu Li
- Department of Radiology, Liuzhou Worker's Hospital, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Gang Liu
- Department of Trauma Center, Liuzhou Worker's Hospital, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Li Zhu
- Department of Radiology, Liuzhou Worker's Hospital, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Tao Li
- Department of Radiology, Liuzhou Worker's Hospital, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
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12
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Xiao-Xue W, Xinyue H, Lijun Z. Whole body FDG-PET/CT for the assessment of bone marrow infiltration in patients with newly diagnosed lymphoma. Med Clin (Barc) 2019; 154:61-65. [PMID: 31757394 DOI: 10.1016/j.medcli.2019.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/09/2019] [Accepted: 07/18/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Positron emission tomography-computed tomography (PET-CT) and bone marrow biopsy are currently the common clinical examination of lymphoma infiltration. The aim of this research is to evaluate the value of PET-CT in diagnosis of bone marrow infiltration, clinical staging and pathological typing of lymphoma. METHODS 153 cases were analyzed retrospectively to compare the consistency of PET-CT and bone marrow biopsy. We analyzed the sensitivity, accuracy and specificity of PET-CT in different clinical pathology of lymphoma. RESULTS The PET-CT sensitivity in detecting bone marrow infiltration is 54.3% with a specificity of 80.5% and accuracy of 74.5%. In aggressive B-cell lymphoma (DLBCL, HG-BL) and MZL, PET-CT results of bone marrow infiltration showed high accuracy of 88.1% and 83.3% respectively. The median value of SUVmax in the patients detected to have bone marrow infiltration by BMB was significantly higher than patients with BMB negative results among subgroups of aggressive B-cell lymphoma, MZL and T-NHL (p<.05). CONCLUSION PET-CT is significant in detecting bone marrow infiltration in certain pathological types of lymphoma. However pathological inconsistencies still exist between bone marrow biopsy and PET-CT, thus PET-CT cannot completely replace biopsy.
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Affiliation(s)
- Wang Xiao-Xue
- Department of Hematology, the First Hospital, China Medical University, Shenyang 110001, China
| | - Huang Xinyue
- Department of Hematology, the First Hospital, China Medical University, Shenyang 110001, China
| | - Zhang Lijun
- Department of Hematology, the First Hospital, China Medical University, Shenyang 110001, China.
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13
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Wang G, Chang Y, Wu X, Li X, Li L, Zhang L, Fu X, Sun Z, Zhang X, Zhang M. Clinical features and prognostic factors of primary bone marrow lymphoma. Cancer Manag Res 2019; 11:2553-2563. [PMID: 31015766 PMCID: PMC6446986 DOI: 10.2147/cmar.s187522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Primary bone marrow lymphoma (PBML) is a very uncommon neoplasm originally arising in the bone marrow system, and the most common pathological type is diffuse large B-cell lymphoma. Patients and methods To describe the clinical characteristics of PBML and evaluate the risk factors related to prognosis, we recruited and studied 66 patients from our center and the current published literature. Various symptoms are present at the onset of PBML, the most important of which is cytopenia, followed by fever. Forty-seven of these patients were included in our analysis. Results Univariate analysis suggested that B symptoms (P=0.024), a low serum platelet level (<75×109/L; P=0.032), an elevated serum LDH level (P=0.039), and not achieving a complete response (CR) following initial therapy (P=0.007) are associated with worse outcomes. Multivariate analysis showed that only a low serum platelet level (<75×109/L), B symptoms, and not achieving a CR following initial therapy are independent factors for prognosis. In addition, intensive regimens appear to be beneficial for prognosis. Conclusion PBML is a lymphoma with special clinical features, and its recognition is important for establishing a definitive prognosis model and searching for appropriate therapy.
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Affiliation(s)
- Gangjian Wang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Yu Chang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Xiaolong Wu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Xin Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Ling Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Lei Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Xiaorui Fu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Zhenchang Sun
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Xudong Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
| | - Mingzh Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China,
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Khalatbari H, Parisi MT, Kwatra N, Harrison DJ, Shulkin BL. Pediatric Musculoskeletal Imaging: The Indications for and Applications of PET/Computed Tomography. PET Clin 2018; 14:145-174. [PMID: 30420216 DOI: 10.1016/j.cpet.2018.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The use of PET/computed tomography (CT) for the evaluation and management of children, adolescents, and young adults continues to expand. The principal tracer used is 18F-fluorodeoxyglucose and the principal indication is oncology, particularly musculoskeletal neoplasms. The purpose of this article is to review the common applications of PET/CT for imaging of musculoskeletal issues in pediatrics and to introduce the use of PET/CT for nononcologic issues, such as infectious/inflammatory disorders, and review the use of 18F-sodium fluoride in trauma and sports-related injuries.
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Affiliation(s)
- Hedieh Khalatbari
- Department of Radiology, University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA.
| | - Marguerite T Parisi
- Department of Radiology, University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA
| | - Neha Kwatra
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Douglas J Harrison
- Department of Pediatrics, MD Anderson Cancer Center, 7600 Beechnut Street, Houston, TX 77074, USA
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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