Malignant Lymphoma
– 1o malignant lymphoma of bone = tumor arising within bone & remaining localized at the original site without extrasseous involvement for at least 6 months
– usu presents in 3rd decade involving distal femur or proximal femur
Signs & Symptoms:
– pain & swelling at tumor site +/- tender soft tissue mass
– usu no constitutional symptoms
Xrays:
– poorly marginated, destructive permeative lesion in diaphysis of long bones
– may be lytic, sclerotic or a mixture of both
– periosteal reaction with cortical thickening
Histology:
– diffuse infiltration of round lymphoid cells varying from small – large cells which have grooved nuclei & conspicuous nucleoli
– areas of spindle cell proliferation with fibrosis
– usu large B-cell type lymphoctyes
Treatment:
– radiation & chemotherapy
– 5 yr survival = 20-50% depending on presence of extraosseous lesions
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