Primary non-Hodgkin’s lymphoma of bone

Vytautas Toliušis, Algimantas Pamerneckas, Algimantas Petrulis, Gintaras Tamulaitis, Giedrius Pilipavičius, Andrėjus Pijadin

Clinic of Orthopedics and Traumatology, Kaunas University of Medicine Hospital, Lithuania

Key words: lymphosarcoma, reticulosarcoma, lymphoblastoma, non-Hodgkin lymphoma, primary lymphoma of bone, pathological fracture of bone.

Summary. Primary lymphoma of bone is a rare condition that has been described as a malignant neoplasm formed of lymphoid and myelopoetic tissues. Morphologic substrate is formed of lymphoid cells of different evolutional stages. Primary lymphoma of bone occurs predominantly in males; a male to female ratio is 1.8:1. It may occur at any age. The sites commonly affected are the long bones. In Lithuania 400 new cases of lymphoma are diagnosed every year. About 75% of them are non-Hodgkin’s lymphoma. Many histological types and subtypes of lymphoma exist. This variation leads to difficulties when reviewing the literature and comparing prognoses, treatment and oncologic outcomes. Treatment options for primary bone lymphoma historically have included local therapy with radiation or surgery with or without systemic therapy. The aim of surgery is prophylactic fixation of impending fractures or treatment of pathological fractures. We present a clinical case report of 40-year-old male who developed primary lymphoma of bone with pathological fracture of femur. The systemic chemotherapy was applied during the time of treatment. The choice of surgical treatment was intramedullary nailing without using of methylmethacrylate, because regeneration of bone was visible on roentgenograms. After twelve-month follow-up the patient is full weight bearing without external support.

Correspondence to V. Toliušis, Clinic of Orthopedics and Traumatology, Kaunas University of Medicine Hospital, Eivenių 2, 50010 Kaunas, Lithuania. E-mail: vtoliusis@xxx.lt

Received 19 January 2004, accepted 30 March 2004