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Malignant lymphoma of bone.

Hans Roland Dürr1, Peter Ernst Müller, Erhard Hiller

  • 1Department of Orthopaedics and Orthopaedic Surgery, University of Rostock, Germany. hans_roland.duerr@med.uni-rostock.de

Archives of Orthopaedic and Trauma Surgery
|May 9, 2002
PubMed
Summary

Malignant bone lymphoma diagnosis is often delayed due to vague symptoms. Soft-tissue masses are key radiologic signs, and prognosis depends on disease extent, not patient factors.

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Malignant lymphoma of bone is a rare condition.
  • Diagnosis is frequently delayed due to nonspecific clinical signs and ambiguous radiographic findings.
  • Treatment is typically multimodal, involving surgery, radiation, and chemotherapy.

Purpose of the Study:

  • To elucidate the clinical and radiological features of malignant bone lymphoma.
  • To optimize diagnostic strategies for this rare entity.
  • To evaluate treatment modalities and prognostic indicators.

Main Methods:

  • Retrospective review of 36 patients surgically treated for malignant bone lymphoma over 15 years.
  • Classification into primary lymphoma of the bone (PLB), disseminated non-Hodgkin's lymphoma (dNHL), and Hodgkin's disease (HD) with bone involvement.

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  • Analysis of clinical presentation, radiological findings, treatment, and survival data.

    • Main Results:

    • The main symptom was pain (8 months average duration).
    • Osteolytic patterns were observed in 58% of lesions; soft-tissue involvement was present in 71% and was a key diagnostic sign.
    • The 5-year survival rate was 61% (PLB 88%, dNHL 38%, HD 50%).
    • Prognosis was significantly influenced by the extent of bone involvement (multiple vs. solitary) and extraskeletal spread.

    Conclusions:

    • Malignant bone lymphoma often presents late with nonspecific symptoms and characteristic soft-tissue masses on imaging.
    • Early diagnosis and appropriate staging are crucial for effective treatment and improved survival.
    • Prognosis is primarily determined by disease dissemination and extent, underscoring the importance of comprehensive staging and management.