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Keane Tahmaseb GC, Keane AM, Foppiani JA, Myckatyn TM. An Update on Implant-Associated Malignancies and Their Biocompatibility. Int J Mol Sci 2024; 25:4653. [PMID: 38731871 PMCID: PMC11083590 DOI: 10.3390/ijms25094653] [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: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.
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Affiliation(s)
- Grace C. Keane Tahmaseb
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
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Ivanova VS, Davies J, Menter T, Wild D, Müller A, Krasniqi F, Stenner F, Papachristofilou A, Dirnhofer S, Tzankov A. Primary bone diffuse large B-cell lymphoma (PB-DLBCL): a distinct extranodal lymphoma of germinal centre origin, with a common EZB-like mutational profile and good prognosis. Histopathology 2024; 84:525-538. [PMID: 37965677 DOI: 10.1111/his.15096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/03/2023] [Accepted: 10/28/2023] [Indexed: 11/16/2023]
Abstract
AIMS Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is not recognized as a separate entity by the current classification systems. Here we define and highlight its distinctive clinical presentation, morphology, phenotype, gene expression profile (GEP), and molecular genetics. METHODS We collected 27 respective cases and investigated their phenotype, performed gDNA panel sequencing covering 172 genes, and carried out fluorescence in situ hybridization to evaluate MYC, BCL2, and BCL6 translocations. We attempted to genetically subclassify cases using the Two-step classifier and performed GEP for cell-of-origin subtyping and in silico comparison to uncover up- and downregulated genes as opposed to other DLBCL. RESULTS Most cases (n = 22) were germinal centre B-cell-like (GCB) by immunohistochemistry and all by GEP. Additionally, PB-DLBCL had a mutational profile similar to follicular lymphoma and nodal GCB-DLBCL, with the exception of more frequent TP53 and B2M mutations. The GEP of PB-DLBCL was unique, and the frequency of BCL2 rearrangements was lower compared to nodal GCB-DLBCL. The Two-step classifier categorized eight of the cases as EZB, three as ST2, and one as MCD. CONCLUSION This study comprehensively characterizes PB-DLBCL as a separate entity with distinct clinical and morpho-molecular features. These insights may aid in developing tailored therapeutic strategies and shed light on its pathogenesis.
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Affiliation(s)
- Vanesa-Sindi Ivanova
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - John Davies
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Thomas Menter
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Damian Wild
- Divison of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Anne Müller
- Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Fatime Krasniqi
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Frank Stenner
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Stefan Dirnhofer
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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Go JH. Metallic implant-associated lymphoma: ALK-negative anaplastic large cell lymphoma associated with total knee replacement arthroplasty. J Pathol Transl Med 2023; 57:75-78. [PMID: 36623817 PMCID: PMC9846009 DOI: 10.4132/jptm.2022.10.30] [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: 08/16/2022] [Accepted: 10/30/2022] [Indexed: 01/11/2023] Open
Abstract
Metallic implant-associated lymphomas are extremely rare. Only seven cases have been reported in association with knee joint arthroplasty, and all tumors were large B-cell lymphomas. This report is the first case of anaplastic large cell lymphoma occurring after total knee replacement arthroplasty. An 80‑year‑old female patient was admitted because of right knee pain for 2 years. She had undergone total knee replacement arthroplasty 10 years prior. Computed tomography showed an irregular osteolytic lesion in the right lateral femoral condyle, adjacent to the metallic prosthesis. Histologic findings reveal sheets of anaplastic tumor cells that were positive for CD2, CD4, CD5, CD43, and CD30 but negative for CD3, CD20, CD15, and anaplastic lymphoma kinase. Epstein-Barr encoding region in situ hybridization was negative. Analysis of T-cell receptor γ gene rearrangement studies using BIOMED-2-based multiplex polymerase chain reaction confirmed monoclonal T cell proliferation. The woman was finally diagnosed with ALK-negative anaplastic large cell lymphoma.
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Affiliation(s)
- Jai-Hyang Go
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
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Jolliffe JB, Edmondson MJ, Pham A, Lim E. Recurrent B-Cell lymphoma in a lower limb reconstructive flap after trauma. ANZ J Surg 2022; 92:3350-3352. [PMID: 35362646 DOI: 10.1111/ans.17657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/22/2022] [Accepted: 02/27/2022] [Indexed: 12/31/2022]
Affiliation(s)
| | - Mark J Edmondson
- Department of Surgery, Plastic, Hand, Faciomaxillary Surgery, Alfred Hospital, Melbourne, Victoria, Australia
| | - Alan Pham
- Department of Pathology, Alfred Health, Melbourne, Victoria, Australia
| | - Eugene Lim
- Department of Plastic and Reconstructive Surgery, Alfred Health, Melbourne, Victoria, Australia
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Diaz-Perez JA, Poveda JC, Chapman JR, Velez-Torres JM, Vega F, Rosenberg AE. Unexpected Primary Extranodal Marginal Zone Lymphoma of Bone in Amputation and Arthroplasty Specimens. Am J Clin Pathol 2021; 156:1038-1043. [PMID: 34075398 DOI: 10.1093/ajcp/aqab067] [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: 11/12/2022] Open
Abstract
OBJECTIVES Amputation due to gangrene and arthroplasty for degenerative joint disease are common orthopedic procedures and are expected to increase as populations age. Histopathologic examination of these specimens can identify unsuspected diseases. METHODS We reviewed gangrenous amputations and large joint arthroplasty specimens for diagnosis of unexpected lymphoma, January 2014 to January 2020. Pathology and medical records were reviewed to determine diagnosis, treatment, and outcome. RESULTS Five cases (0.08%) of unexpected primary extranodal marginal zone lymphoma (MZL) centered in bone were identified in 1,624 amputations for gangrene and 4,163 arthroplasty specimens. The female-to-male distribution was 3:2. Median age was 71 years (range, 62-87). The 3 cases arising in the setting of gangrene involved the first toe phalanges and metatarsals, and the femoral head was involved in all cases of joint disease (2 cases). The bone showed variable (10%-80%) infiltration by dense populations of small lymphoid cells with MZL immunophenotype. One patient died from sepsis 18.5 months after diagnosis; all others are alive with a median follow-up of 27.45 months. CONCLUSIONS Histopathologic examination of nonneoplastic orthopedic specimens identifies unexpected primary bone extranodal MZL in a small percentage of cases. This neoplasm may be the result of chronic antigenic stimulation in some circumstances.
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Affiliation(s)
- Julio A Diaz-Perez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julio C Poveda
- Division of Hematopathology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer R Chapman
- Division of Hematopathology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jaylou M Velez-Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Francisco Vega
- Division of Hematopathology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Hall J, Kampfer C, Williams N, Osswald M, Bishop B, Hall M, Alderete J. Fibrin-Associated Diffuse Large B Cell Lymphoma Found on Revision Arthroplasty of the Knee. South Med J 2021; 114:708-713. [PMID: 34729615 DOI: 10.14423/smj.0000000000001321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Fibrin-associated diffuse large B cell lymphoma (FA-DLBCL) is a rare Epstein-Barr viruspositive B cell lymphoma that is nonmass-forming, does not directly produce symptoms, and is incidentally discovered on histological examination of tissues excised for other reasons. Despite overlap in morphologic and immunophenotypic features with aggressive B cell neoplasms, FA-DLBCL shows an excellent clinical outcome, even with surgical excision alone. We report an extremely rare occurrence of FA-DLBCL found in association with a metallic implant on revision arthroplasty of the knee. This report also illustrates the need for an integrated multidisciplinary approach for accurate diagnosis and avoidance of overtreatment.
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Affiliation(s)
- Jordan Hall
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Craig Kampfer
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Ned Williams
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Michael Osswald
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Bradie Bishop
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Misty Hall
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
| | - Joseph Alderete
- From the Departments of Pathology, Orthopedic Surgery, Radiation Oncology, and Hematology Oncology, Brooke Army Medical Center, Joint Base San Antonio, Texas
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Ramos-Gallardo G, Carballo-Zarate AA, Cuenca-Pardo J, Cárdenas-Camarena L, Solano-Genesta M, Beltrán JAC, Gallagher-Hernandez S, Contreras-Bulnes L, Vélez-Benitez E, Bucio-Duarte JJ, Cedillo-Alemán EJ. What is the Evidence of Lymphoma in Patients with Prostheses Other Than Breast Implants? Aesthetic Plast Surg 2020; 44:286-294. [PMID: 31844943 DOI: 10.1007/s00266-019-01569-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Medical devices such as hip, knee, breast, vascular prostheses, among others, are very useful in different pathologies. We cannot doubt that their use is a great tool, besides being an advance in medicine; they provide a change in the quality of life of many patients; however, they are not exempt from adverse reactions and events. METHODS We conduct a systematic review about lymphoma in the presences of prostheses other than breast implants. RESULTS We selected 21 publications with a total of 24 patients. The largest number of prostheses was related to long bones in a total of 13 prostheses. The most frequent symptoms were: pain (52%), inflammation (24%), visible or palpable mass 20%. The most frequent type of lymphoma was non-Hodgkin B cell lymphoma in 14 cases. DISCUSSION The presence of microparticles make biological degradation and wear of the implants, with macrophage and lymphocyte activation and the consequent production of proinflammatory cytokines such as tumor necrosis factor α, interleukin-1β, interleukin-6, and prostaglandin 2 (PGE2). CONCLUSION Lymphoma is not a common disease in patients with prostheses, and more data are needed to identify risk factors and make proper diagnoses. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Guillermo Ramos-Gallardo
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico.
- Centro Universitario de la Costa, Universidad de Guadalajara, Puerto Vallarta, Mexico.
| | | | - Jesús Cuenca-Pardo
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Lázaro Cárdenas-Camarena
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | | | | | | | - Livia Contreras-Bulnes
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Estela Vélez-Benitez
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - José Javier Bucio-Duarte
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Enrique Javier Cedillo-Alemán
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
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Rashid S, Mohamed SF, Yassin M, Tbishat LF, Al-Thani H, Albozom I. Intramural great vessel lymphoma presenting as thrombus in an aortic aneurysm. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature. Case Rep Orthop 2019; 2019:3174768. [PMID: 30944745 PMCID: PMC6421802 DOI: 10.1155/2019/3174768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/19/2019] [Accepted: 02/03/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Primary bone lymphoma (PBL) is a rare bone malignancy which may present with atraumatic pain, swelling, or pathological fracture. Whilst the femur is the most commonly affected site, any bone may be involved. PBL should be distinguished from other bone lesions to determine clinical management. Case Report We report the case of an 89-year-old gentleman who presented to the local emergency department with atraumatic hip pain and inability to weight-bear. Multimodal imaging showed evidence of a tumor involving the proximal femur and adjacent acetabulum with an associated pathological intertrochanteric fracture. Biopsy specimens demonstrated this to be PBL of the diffuse large B-cell subtype. No other disease foci or nodal involvement was identified. The patient underwent proximal femoral replacement and acetabular reconstruction prior to commencing R-Mini-CHOP chemotherapy, during which time he has been permitted to fully weight-bear. Conclusion To our knowledge, this is the first reported case of a patient having PBL with both femoral and acetabular involvements. Due to its infrequent occurrence, evidence remains limited to advise therapeutic guidelines. Our practice concurs with literature suggesting that surgery be reserved for cases of pathological fracture. However, the merits of undergoing surgical fixation prior to chemoradiation treatment have been considered.
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Chi-Kin L, Chun-Kit L, Koon-Ho T, Yiu-Chung W. Non-Hodgkin Lymphoma Mimics Infected Total Knee Arthroplasty. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2018. [DOI: 10.1016/j.jotr.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Lymphoma associated with total knee arthroplasty is a rare condition. We report a case of non-Hodgkin lymphoma mimicking an infected total knee arthroplasty. A 73-year-old woman who received left total knee replacement presented with fever and a discharging sinus over her left knee 12 weeks after surgery. The diagnosis of prosthetic joint infection was made and a two-stage revision arthroplasty planned. After implant removal and insertion of an antibiotic spacer in the first-stage operation, culture results of all intraoperative specimens were negative but the pathology report showed diffuse large B-cell lymphoma. She then received chemotherapy and a second-stage reconstruction operation. The wound healed uneventfully and she regained independent mobility.
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Affiliation(s)
- Lo Chi-Kin
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Lai Chun-Kit
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Tsang Koon-Ho
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Wong Yiu-Chung
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
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Sunitsch S, Gilg M, Kashofer K, Leithner A, Liegl-Atzwanger B, Beham-Schmid C. Case Report: Epstein-Barr-Virus negative diffuse large B-cell lymphoma detected in a peri-prosthetic membrane. Diagn Pathol 2016; 11:80. [PMID: 27539226 PMCID: PMC4990836 DOI: 10.1186/s13000-016-0533-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/11/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Primary bone lymphomas (PBL) are extremely rare malignant neoplasms. The most commonly described subtype of PBL is diffuse large B-cell lymphoma (DLBCL). DLBCL within peri-prosthetic membrane of a joint is exceedingly rare. To the best of our knowledge this case is the second reported Epstein-Bar-Virus (EBV) negative DLBCL in a peri-prosthetic membrane in the literature. CASE PRESENTATION We report an 80 year old female patient who developed a DLBCL with chronic inflammation in association to a metallic implant in the left knee. This lymphoma in contrast to the usually described DLBCL in the peri-prosthetic membrane was EBV negative by EBER in situ hybridization as well as by polymerase chain reaction (PCR). CONCLUSION This report challenges the concept of DLBCL associated with chronic inflammation and raises the question of other pathogenetic factors involved in the pathogenesis of this rare disease.
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Affiliation(s)
- Sandra Sunitsch
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Magdalena Gilg
- Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Graz, Austria
| | - Karl Kashofer
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Andreas Leithner
- Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Graz, Austria
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Abstract
The emerging epidemic of Hodgkin and non-Hodgkin lymphomas worldwide continues to defy our understanding and forces the search for the causative factors. Adjuvants are known to act as triggers of immune and inflammatory responses. Animal experiments have demonstrated that long-term inflammation is related to aggravation of the immune network resulting in cellular and humoral responses leading to autoimmunity and lymphoma development. Chronic stimulation of the immune system is thought to be the key mechanism through which infectious diseases as well as autoimmune diseases can lead to lymphomagenesis. Many adjuvants can act similarly perturbing immune system's function, inducing a state of prolonged immune activation related to chronic lymphatic drainage. Several mechanisms were proposed by which adjuvants induce inflammation, and they are discussed herein. Some of them are triggering inflammasome; others bind DNA, lipid moieties in cells, induce uric acid production or act as lipophilic and/or hydrophobic substances. The sustained inflammation increases the risk of genetic aberrations, where the initial polyclonal activation ends in monoclonality. The latter is the hallmark of malignant lymphoma. Thus, chronic adjuvant stimulation may lead to lymphoma.
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Ibrahim I, Haughom BD, Fillingham YA, Brown N, Gitelis S. Primary Lymphoma of Bone Complicating Total Knee Arthroplasty: An Unexpected Mode of Prosthesis Failure: A Case Report. JBJS Case Connect 2015; 5:e34. [PMID: 29252596 DOI: 10.2106/jbjs.cc.n.00167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE Primary lymphoma of bone is a rare musculoskeletal malignancy that typically arises in long bones. Few cases of bone lymphoma occurring alongside orthopaedic implants have been reported in the literature. We describe the complex case of a seventy-eight-year-old woman who developed diffuse large B-cell lymphoma of the proximal part of the tibia five years after a successful total knee arthroplasty. CONCLUSION Several studies have suggested a link between orthopaedic implants and genomic instability, although true carcinogenesis remains questionable. Lymphoma complicating joint arthroplasty poses a unique problem for orthopaedic physicians due to diagnostic challenges and the unique implications of disease and treatment-related complications.
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Affiliation(s)
- Ishaq Ibrahim
- Rush University School of Medicine, 600 South Paulina Street, Chicago, IL 60612.
| | - Bryan D Haughom
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Yale A Fillingham
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Nicholas Brown
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Steven Gitelis
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
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McCammon J, Mascarenhas R, Monument MJ, Elyousfi A, Pilkey B. Large B-cell lymphoma mimicking iliopsoas abscess following open revision of proximal femur infected non-union: a case report. BMC Res Notes 2014; 7:470. [PMID: 25056400 PMCID: PMC4120726 DOI: 10.1186/1756-0500-7-470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 07/15/2014] [Indexed: 11/21/2022] Open
Abstract
Background Extranodal presentation of lymphoma is a rare occurrence. It has been postulated that chronic antigen stimulation may predispose a patient to the development of lymphoma. Case presentation We present a case report of a large extranodal B-cell lymphoma mimicking a postoperative abscess following surgery for an infected proximal femur nonunion in an 80-year-old Caucasian male of Italian descent. Conclusions This case highlights the need to consider malignancy in revision surgery, careful examination of operative specimens and the need for further understanding of the role of metal implants in chronic antigen stimulation.
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Affiliation(s)
- James McCammon
- Section of Orthopedic Surgery, Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada.
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e31827525d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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