Immunohistochemistry in Primary B-cell Lymphoma of Tibia Masquerading as Chronic Osteomyelitis

The diagnosis between chronic osteomyelitis, Ewing sarcoma and lymphoma often is being confusing in many occasions. As the latter two conditions are malignant, early diagnosis and interventions are crucial. We present a 28 year old male with features of chronic osteomyelitis of right tibia 2 years back then changed through Ewing sarcoma to B-cell lymphoma in the histological diagnosis. This case report highlights the difficulties that arise in diagnosing primary bone lymphomas which may masquerade as chronic osteomyelitis and hence the need for immunohistochemistry in chronic recurrent osteomyelitis.