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Journal of Cancer Research and Therapeutics
Medknow Publications on behalf of the Association of Radiation Oncologists of India (AROI)
ISSN: 0973-1482 EISSN: 1998-4138
Vol. 5, Num. 4, 2009, pp. 331-331

Journal of Cancer Research and Therapeutics, Vol. 5, No. 4, October-December, 2009, pp. 331

Letter To Editor

Primary non-Hodgkin lymphoma of the bone

Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons of Columbia University, New York

Correspondence Address:Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons of Columbia University, New York
fahadaziz.md@gmail.com

Code Number: cr09081

PMID: 20160378

DOI: 10.4103/0973-1482.59899

Sir,

I read with great interest the recent case report by Ronald et al., about an unusual presentation of primary non-Hodgkin lymphoma. [1] I congratulate the authors for presenting this case report in a very effective way. I want to explain some more facts about primary bone lymphoma to enhance the interest of the readers.

Male predominance, higher likelihood of early stage presentation, and a median age predominance of the fifth or sixth decade are usual features of primary bone lymphoma. [2] Primary lymphoma of the bone also known as reticulum cell sarcoma, malignant lymphoma of the bone, and more recently osteolymphoma usually manifests with insidious and intermittent bone pain that can persist for many months. Other signs and symptoms include local swelling, palpable mass, and systemic features like weight loss and fever.

Although boney involvement of disseminated malignant lymphoma is not uncommon, primary lymphoma of bone is infrequent. Primary bone lymphoma is mostly large-cell or mixed small- and large-cell lymphoma of the B-cell lineage. [3] It usually affects the long bones, indeed its very unusual presentation in this case report where it affects the proximal phalanx of the right thumb.

On the basis of radiological characteristics, primary bone lymphoma can be divided into three groups: (1) lytic destructive pattern, (2) blastic sclerotic pattern, and (3) subtle or near-normal pattern. [3]

In general, limb-sparing radiation therapy was considered as the gold standard in 1960s with a curing rate of 44-63%. But now patients with monostatic primary bone lymphoma treated with a combination of radiation therapy and chemotherapy do well. [2]

References

1.Pinheiro RF, Filho FD, Lima GG, Ferreira FV. Primary non-Hodgkin lymphoma of bone: An unusual presentation. J Cancer Res Ther 2009;5:52-3.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Beal K, Allen L, Yahalom J. Primary bone lymphoma: Treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer 2006;106:2652-6.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Krishnan A, Shirkhoda A, Tehranzadeh J, Armin AR, Irwin R, Les K. Primary bone lymphoma: Radiographic-MR imaging correlation. Radiographics 2003;23:1371-83; discussion 1384-7.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]

Copyright 2009 - Journal of Cancer Research and Therapeutics

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