Non-Hodgkin Lymphoma of Bone
Synonyms: Primary Bone NHL, Bone lymphoma
Rare primary Bone malignancy
Quick Facts
Behaviour
Malignant
Category
Bone
Grade
High
Synonyms
- Primary Bone NHL
- Bone lymphoma
Category
Bone
Behaviour
Malignant
Grade
High
Gender
M = F
Tissue of Origin
Other
Epidemiology
- Rare primary Bone malignancy
- <1% of NHL cases
- Peak incidence in older adults
- Predilection for femur and pelvis
Clinical Features
- Bone pain
- Pathological fracture
- Constitutional symptoms (B symptoms) less common than systemic NHL
Location
- Femur most common
- Pelvis
- Tibia
- Humerus
Imaging
- Plain radiograph: lytic or mixed lesion
- MRI: homogeneous lesion with extensive soft tissue
- PET-CT: FDG avid; assess for other lesions
Pathology
- Clonal B-cell lymphoma (usually DLBCL)
- CD20+, CD79a+, Ki67 High
Genetics
Recurrent translocations depend on subtype
Treatment
- Chemotherapy (R-CHOP or similar)
- Radiotherapy to primary site
- Assess for systemic involvement
Prognosis
- Variable by histology and stage
- 60% 5-year survival with modern R-CHOP
Key Points
- Rare primary Bone malignancy
- Usually DLBCL histology
- Assess for systemic involvement before treatment
Workup - Blood Tests
- FBC, U&E, LFTs, LDH - baseline
- Coagulation screen
Workup - Local Imaging
- Plain radiograph
- MRI Bone - assess primary lesion and marrow involvement
Workup - Biopsy
Core needle or open biopsy - must send fresh for flow cytometry and gene rearrangement studies
Workup - Staging
- CT chest/abdomen/pelvis - systemic staging
- PET-CT - disease burden
Workup - Other
- Haematology/oncology MDT
- Assess for CNS involvement (LP if indicated)
Follow-up Summary
- 1
Post-operative check at 6 weeks + xray of involved bone
- 2
Year 1
6 monthly xrays
Medical disclaimer
The content on Sarcopedia is for educational and informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical diagnosis or treatment. Always consult with a qualified physician regarding any health concerns or before starting any new treatment. Reliance on any information provided on this site is solely at your own risk.