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Updated: Jun 24, 2026
06:53
Modeling Primary Bone Tumors and Bone Metastasis with Solid Tumor Graft Implantation into Bone
Published on: September 9, 2020
[Primary osseous lymphoma with pathological fracture during therapy]
Yuichi Murakami1, Jun Yamanouchi, Taichi Azuma
1Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine.
Summary
A rare case of primary bone lymphoma in a 66-year-old woman led to unexpected pathologic fractures during chemotherapy. This highlights the importance of monitoring bone health in lymphoma patients undergoing treatment.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Primary bone lymphoma is a rare malignancy.
- Diffuse large B-cell lymphoma (DLBCL) can present with bone involvement.
- Chemotherapy regimens like CHOP and rituximab are standard treatments for DLBCL.
Observation:
- A 66-year-old woman diagnosed with CD20-positive diffuse large B-cell lymphoma presented with a cervical tumor.
- Ga-67 scintigraphy revealed abnormal uptake in multiple skeletal sites, not evident on plain radiography or CT.
- MRI showed characteristic signal changes in the affected femur.
Findings:
- The patient developed pathologic fractures of the left tibia/fibula and right femur neck during CHOP and rituximab therapy.
- Fracture sites corresponded to areas of abnormal Ga-67 uptake, suggesting chemotherapy-associated fractures.
- The cervical tumor showed a prompt reduction in size with chemotherapy.
Implications:
- This case underscores the potential for chemotherapy-induced bone fragility in patients with primary bone lymphoma.
- Radiographic and CT-negative bone lesions detected by scintigraphy may still be at risk for fracture.
- Close monitoring for skeletal complications is crucial in patients with rare bone malignancies undergoing treatment.
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