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Rare Case of Primary Bone Lymphoma
Madeline L Fudala1, Imad Karam1, Aye M Thida1
1Hematology and Oncology, State University of New York, Downstate Health Sciences University, Brooklyn, USA.
Cureus
|June 19, 2025
Summary
This case report details a rare instance of primary bone lymphoma (PBL) in an elderly woman, presenting with unusual skin lesions and swollen lymph nodes. The findings highlight the diagnostic challenges and atypical presentations of this bone cancer.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Primary bone lymphoma (PBL) is a rare lymphoid neoplasm originating in bone without lymph node or extranodal involvement.
- PBL diagnosis can be challenging due to nonspecific clinical presentations and varying diagnostic criteria.
Observation:
- A 73-year-old female presented with a pathologic tibial fracture, cutaneous lesions, and regional lymphadenopathy, initially misdiagnosed as Paget's disease.
- Histopathology and immunohistochemistry confirmed PBL with large lymphoid cells (CD10+, CD20+, Bcl6+, high Ki-67).
Findings:
- This case represents the first documented instance of PBL with concurrent cutaneous manifestations and regional lymph node involvement.
- The patient's extranodal disease and risk factors placed her at high-intermediate risk (NCCN-IPI) and intermediate risk for CNS disease.
Implications:
- This case expands the understanding of PBL's atypical presentations, suggesting potential for extranodal spread beyond bone.
- Highlights the importance of comprehensive evaluation for accurate diagnosis and risk stratification in suspected PBL cases.
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