4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

Clinical Cytology - Plenary and Invited Lectures
BONE LESIONS IN LYMPHOMA
Planinc-Peraica A, Radić-Krišto D, Ostojić Kolonić S, Kardum-Skelin I, Jakšić B
Department of Medicine, University Hospital Merkur, Zagreb
Bone lesions are rare events in patients with haematologic neoplasm except those with
adult T-cell leukaemia lymphoma associated with HTLV-1 infection, and multiple myeloma.
Primary lymphoma of bone is rare manifestation of this disease, and less than
5% of all extranodal lymphomas are localized in bones. The most common localization
is the long bones, and localized bone pain is usual accompanying symptom. Sometimes
patients have systemic symptoms and multiple osteolyses. Less than 10% of patients
with malignant lymphoma develop bone lesions during the course of their disease. Hypercalcaemia
is rare in primary lymphoma of bone.
In six years period at University Hospital “Merkur” out of 698 lymphoma patients bone
lesions were diagnosed in 7 patients (3 men, 4 women, age - range 22 to 66 years, median
of age 58 years). Two newly diagnosed patients with diffuse large B-cell lymphoma
(DLBCL) had primary lymphoma of bone without lymph node involvement. In 5 patients
bone lesions were discovered during the course of disease. In all patients localized bone
pain was dominant symptom. No one patient had hypercalcaemia. In the course of their
disease secondary bone lesions appeared in two patients with indolent lymphoma, in
one patient with DLCB, and in two patients with Hodgkin’s disease, type mixed cellularity.
Localization of primary bone lymphoma was femur, and rib, while secondary lymphoma
lesions were in backbone, and pelvis. Patients were treated with chemotherapy
(COP-R, CHOP, CHOP-R for lymphoma, and ABVD, LVPP, BEACOP for Hodgkin’s disease)
combined with radiotherapy only in three patients. Three patients died. The median of
survival is 75 months.
We concluded that primary bone lesions of lymphoma are rare conditions. Correct diagnosis
is very important because primary lymphoma of bone has a relatively favorable
prognosis.
ananas2907@hotmail.com
57
4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology