Age / Sex : 51 / M

Age / Sex : 51/M

Chief complaint :Palpable mass in lef inguinal region

primary osseous lymphoma

Discussion

Findings:

Plain radiographs :

difficult to detect in plain radiographs

             permeative, osteolytic, mixed lytic and sclerotic pattern of bone destruction,

ill-defined margin, periosteal reaction-not prominent

 MR :

Focal or diffuse lesions of low signal intensity in T1-weighted images and high signal intensity in T2-weighted images

Large extraosseous mass formation

Differential Diagnosis: Metastasis, multiple myleoma, Ewing sarcoma

Diagnosis: primary osseous lymphoma

Discussion: Primary osseous lymphoma is defined as a lymphoma arising from the bone without evidence of the extraskeletal disease at the time of clinical staging studies. The lytic destructive pattern seen in primary lymphoma of bone may be explained by the presence of osteoclast-stimulating factor in the lesion.

Two imaging patterns suggest marrow replacement processes like primary lymphoma of bone. One is marked abnormality on radionuclide imaging or MR imaging with normal or nearly normal findings on radiography. The second imaging pattern suggesting primary lymphoma of bone is shown best by MR imaging. It is a focus of marrow replacement and a surrounding soft-tissue mass without large areas of cortical bone destruction.  

References:

Kirsch J, Ilaslan H, Bauer TW, Sundaram M. The incidence of imaging findings, and the distribution of skeletal lymphoma in a consecutive patient population seen over 5 years. Skeletal Radiol 2006;35:590-594 

Mulligan ME, McRae GA, Murphey MD. Imaging features of primary lymphoma of bone. AJR 1999;173:1691-1697