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DOI: 10.1148/rg.236025056
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(Radiographics. 2003;23:1371-1383.)
© RSNA, 2003

EDUCATION EXHIBIT

Primary Bone Lymphoma: Radiographic–MR Imaging Correlation1

Anant Krishnan, MD, Ali Shirkhoda, MD, Jamshid Tehranzadeh, MD, Ali R. Armin, MD, Ronald Irwin, MD and Kimberly Les, MD

1 From the Departments of Diagnostic Radiology (A.K., A.S.), Pathology (A.R.A.), and Orthopedic Oncology (R.I., K.L.), William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073; and Department of Radiological Sciences and Orthopedics, University of California, Irvine (J.T.). Presented as an education exhibit at the 2001 RSNA scientific assembly. Received March 14, 2002; revision requested April 16; revision received February 24, 2003; accepted March 24. Address correspondence to A.K. (e-mail: tadaastu@yahoo.com).

Primary bone lymphoma is an uncommon malignancy that accounts for less than 5% of all primary bone tumors. The radiographic appearances of primary bone lymphoma are variable, and, because the lesion can appear near normal on plain radiographs, a second modality such as bone scintigraphy or magnetic resonance (MR) imaging should be used. Despite this variability, the presence of a solitary, permeative, metadiaphyseal lesion with a layered periosteal reaction on plain radiographs and a soft-tissue mass on MR images, especially in a patient older than 30 years, is highly suggestive of lymphoma. The case for a diagnosis of primary bone lymphoma is further strengthened if the soft-tissue mass and marrow changes are associated with surprisingly little cortical destruction. Primary bone lymphoma has a better prognosis than many other malignant bone tumors; therefore, early identification allows for appropriate treatment. MR imaging not only permits early identification but also depicts the extent of soft-tissue involvement and can be used to assess the outcome of treatment.

© RSNA, 2003

Index Terms: Bone neoplasms, 40.343 • Lymphoma, 40.343 • Lymphoma, MR, 40.12141


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Invited Commentary • Authors' Response
B. J. Manaster, Jamshid Tehranzadeh, Anant Krishnan, and Ali Shirkhoda
RadioGraphics 2003 23: 1384-1387. [Full Text] [PDF]





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