Primary Non-Hodgkin's Lymphoma of Bone: a Rare Cause of Lytic Bone Lesion

M Tong, TK Yau, WC Wu, JJ Lam, AWM Lee

Hong Kong J Radiol 2004;7:24-30

Objective: To review the clinical behaviour and treatment outcome of patients with localised primary lymphomas of bone.

Patients and Methods: The medical records of patients with primary lymphomas of bone managed at the Pamela Youde Nethersole Eastern Hospital, Hong Kong, from 1994 to 2001 were retrospectively reviewed. Five Chinese patients with this condition were identified. All patients had diffuse large cell lymphomas (New Working Formulation) of B-cell phenotype and were classified as stage IE/IIE by Ann Arbor staging. Four of the 5 patients presented with lytic bone lesions in the long bones of the lower limbs and the remaining patient presented with a lytic lesion in the vertebrae. All patients were treated with anthracycline-based combination chemotherapy, followed by radiotherapy of 40 to 44 Gy.

Results: The median follow up was 60 months (range, 28 to 73 months). All patients achieved complete remission after treatment and remained disease-free up to the last assessment. One patient had a complication of fracture during chemotherapy but no late adverse effects on bone healing due to radiotherapy were identified.

Conclusions: These results suggest that combined chemotherapy and radiotherapy for localised primary lymphomas of bone can provide excellent local and systemic disease control. Radiotherapy following chemotherapy at doses of approximately 40 to 44 Gy appears to be sufficient for local control of the tumour, with no significant adverse effects on bone healing observed.