Primary B-cell lymphoma of the pelvis bone in a young patient: Imaging features of a rare case.

Nghi C. Nguyen^1*, Mujahid Khan¹, Muhammad Shah¹

¹Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

*Corresponding author: Nghi C. Nguyen, MD, PhD, Assistant Professor of Radiology, University of Pittsburgh. UPMC Presbyterian, 200 Lothrop Street (at Meyran Ave), East Wing, 2nd Floor, Suite 200, Pittsburgh, PA 15213. Phone: 412-647-0104; E-mail:

Citation: Nghi Nguyen, et al. Primary B-cell lymphoma of the pelvic bone in a young patient: Imaging features of a rare case. Cancer Research Frontiers. 2017; 3(1): 51-55. doi: 10.17980/2017.51

Copyright: @ 2017 Nghi Nguyen, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Competing Interests: The authors declare no competing financial interests.

Received Feb 24, 2017; Revised Apr 17, 2017; Accepted Apr 24, 2017. Published May 9, 2017.

Abstract

Bone scan of an 18-year-old male who initially presented with chronic left knee pain showed increased radiotracer uptake in the left knee indicative of osteoarthritis. For the incidental finding of diffusely intense uptake involving the left hemipelvis, Paget’s disease was favored over osteosarcoma and Ewing’s sarcoma. CT scan without IV contrast showed cortical and trabecular thickening of the hemipelvis. However, it was not until the MRI study that showed findings inconsistent with Paget’s disease and suspected primary bone lymphoma because of the extensive T1 signal loss due to bone marrow replacement with contrast enhancing soft tissue in the absence of cortical bone destruction, with histopathology revealing extranodal diffuse large B-cell lymphoma. We present a rare case of Non-Hodgkin’s lymphoma occurred in a young patient and illustrate the diagnostic difficulty of primary bone lymphoma as well as emphasize the importance of multi-modality correlation for the differential diagnosis of Paget’s disease vs. primary bone lymphoma.

Keywords: Primary bone lymphoma; B-cell lymphoma; radionuclide bone scan; computed tomography; magnetic resonance imaging