Lymphoma presenting as a solitary bone lesion

Area of Science:

• Oncology
• Pathology
• Immunology

Background:

• Primary lymphoma of bone presents with distinct clinical and radiologic signs.
• However, its histological characteristics and patient outcomes exhibit significant variability.
• Understanding these features is crucial for effective treatment strategies.

Purpose of the Study:

• To compare the histological and immunophenotypic features of primary bone lymphoma in adult patients with their clinical outcomes.
• To identify potential prognostic markers within these lymphomas.

Main Methods:

• Analysis of histological and immunophenotypic features of 13 adult patients with solitary bone lesions diagnosed with non-Hodgkin lymphoma.
• Comparison of these features with clinical outcomes, including disease progression, recurrence, and survival.
• Assessment of CD30 expression and nuclear morphologic features.

Main Results:

• All studied tumors were non-Hodgkin lymphoma (anaplastic or large cell type), with B-cell, T-cell, or null cell phenotypes.
• Initial response to chemotherapy/radiotherapy was good, but 6 patients progressed/recurred, and 5 died.
• CD30 expression (7 cases) correlated with anaplastic/large noncleaved histology; absence (6 cases) correlated with multilobate/cleaved features.
• Recurrence (5/6 cases) was linked to CD30 expression and anaplastic features.
• Tumors with cleaved/multilobate morphology showed long disease-free survival.

Conclusions:

• Primary bone lymphoma exhibits diverse histological and clinical behaviors.
• CD30 expression and specific morphologic features are associated with different prognoses.
• Lymphomas with cleaved or multilobate nuclear features may represent a distinct subtype with a favorable prognosis.