Primary bone lymphoma of radius and tibia: A case report and review of literature

Abstract

Rationale: Primary bone lymphoma (PBL) is a rare malignant entity. There is a better survival of PBL than any other malignant bone tumors and extranodal lymphomas.

Patient concerns: We report a rare case of PBL involving radius and tibia. The patient was a 14-year-old girl with left forearm pain and swelling after trauma. Six months later after the last chemotherapy and radiotherapy, pain and swelling of left knee was presented.

Diagnoses: Radiological imaging revealed a lytic destruction, periosteal reaction, and pathological fracture of radius and tibia with soft tissue mass. Surgical biopsy was performed, and the result of histopathological diagnosis was diffused large B-cell lymphoma (stage IV, group A).

Intervention: Chemotherapy combined with radiotherapy was applied before curation.

Lessons: Due to its uncommon presentation, PBL should be taken into consideration if differential diagnosis from other bone tumors is necessary in clinic.

Figure 1

Computed tomography (CT) multiplanar reconstruction images (A, C) showed an osteolytic lesion in the distal of left radius, with periosteal reaction, pathologic fracture with surrounding soft tissue mass (B, D).

Figure 2

Primary bone lymphoma, with circumferential soft-tissue mass was shown as homogeneously hyperintensity on T2-weighted image (A), homogeneously isointensity on T1-weighted image (B) with obvious enhancement (C, D).

Figure 3

Histopathologic examination (200×) showed lymphoma cells diffuse infiltrating in bone tissue (A) with CD20 positivity (100×) (B), Bcl-6 positivity (100×) (C), and strong Ki-67 positivity (100×) (D).

Figure 4

Soft-tissue swelling and osteolytic destruction of left tibia with cortical fracture were shown in CT images (A, B). CT = computed tomography.