Primary lymphoma of bone: a review of 13 cases emphasizing orthopaedic problems

The records of 13 patients treated in the radiotherapy department in Newcastle 1973-1988 for primary lymphoma of bone (PLB) were reviewed. Treatment was by radiotherapy in combination with surgery and/or chemotherapy. Cause-specific disease-free survival at 5 years in 75%. Eight patients had PLB in a weight-bearing bone: four of these patients suffered pathological fractures in the treated bone. The radiological differentiation of recurrent PLB and radiation osteitis remains unsatisfactory. None of the four post-treatment pathological fractures in this series was due to recurrent PLB. None of these fractures healed spontaneously. All four patients remain disease-free but all have restricted mobility and require walking aids. PLB in weight-bearing bones is associated with long-term fragility and propylactic stabilization of the affected bone should be considered.