Primary DLBCL lymphoma in sacral bone – case report
Authors:
D. Do 1; J. Beneš 2,3; Š. Bátěk 1; P. Choniawko 1; O. Lang 1
Authors place of work:
Klinika radiologie a nukleární medicíny, 3. LF UK a FN KrálovskéVinohrady Praha 10
1; Klinika radiologie, 1. LF UK a Všeobecné fakultní nemocnice Praha 2
2; Proton Therapy Center Czech s. r. o., Praha 8, ČR
3
Published in the journal:
NuklMed 2023;12:32-36
Category:
Casuistry
Summary
Primary bone lymphoma is a very rare and surprising diagnosis. We present a case of 37years old woman with primary sacral diffuse large B-cell lymphoma (DLBCL), supplemented with images from imaging studies and histopathological report.
Patient suffered from spontaneous fractures and pain for several years prior to the last hospitalisation. She underwent analysis of biochemical profile and blood count, a three-phase bone scintigraphy, pelvic CT and MRI. Biopsy from sacral bone was processed as formalin-fixed paraffin-embeded blocs (FFPE), sections were stained by standard and immunohistochemical methods. 18F-FDG PET/CT scan was performed for lymphoma staging.
Three-phase bone scintigraphy did not show abnormity in blood circulation or tissue perfusion in the course of the first and second phase. However, in the delayed phase, we observed an accumulation defect with rim of higher radiotracer accumulation on SPECT/low dose CT corresponding to osteolytic focus with rim of increased bone remodelling. Histopathological examination led to diagnosis of DLBCL, germinal center B-cell like (GBC-like) subtype.
A three-phase bone scintigraphy significantly helped to disclose DLBCL in atypical location. Early diagnosis of DLBCL was followed by appropriate treatment, which resulted in stabilization of disease.
Keywords:
DLBCL – three-phase bone scan – sacrum
Zdroje
- Věstník MZ ČR 2-2016. [online]. 2016 [cit. 2023-05-08]. Dostupné na: https://www.mzcr.cz/vestnik/vestnik-c-2-2016/
- Amer KM, Munn M, Congiusta D, et al. Survival and Prognosis of Chondrosarcoma Subtypes: SEER Database Analysis. Journal of Orthopaedic Research.2020;38:311–319
- Motififard M, Hatami S, Soufi GJ, Periosteal chondroma of pelvis-an unusual location. Int J Burns Trauma.2020;10:174–180
- Rossleigh MA, Smith J, Yeh SDJ, Scintigraphic Features of Primary Sacral Tumors. J Nuc Med.1986;27:627-630
- Kozák Š, Lang O, Obraz chordomu sakrální oblasti na třífázové scintigrafii skeletu a při scintigrafickém vyšetření značenými leukocyty. NuklMed 2017;6:32-35
- Ramadan KM, Shenkier T, Sehn LH et al. A clinicopathological retrospective study of 131 patients with primary bone lymphoma: A population-based study of successively treated cohorts from the British Columbia Cancer Agency. Annals of Oncology.2007;18:129–135
- Mofidi A, Esfandbod M, Pendar E, et al. Primary diffuse large B-cell lymphoma of the bone mimicking osteomyelitis. Clin Case Rep.2021;00:e04724
- Shimada A, Sugimoto KJ, Wakabayashi M, et al. Primary sacral non-germinal center type diffuse large B-cell lymphoma with MYC translocation: a case report and a review of the literature. Int J Clin Exp Pathol. 2013;6:1919–1928
- Xu T, Fu W, Zhang X, et al. Case of Primary Sacral Lymphoma Evaluated by 18F-FDG PET/CT. Clin Nucl Med.2020;45: 888–889
- Hans CP, Weisenburger DD, Greiner TC, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood.2004;103:275–282
Štítky
Nuclear medicine Radiodiagnostics RadiotherapyČlánok vyšiel v časopise
Nuclear Medicine
2023 Číslo 2
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