Imaging Features and Misdiagnostic Analysis of Primary Bone Lymphoma

GAO Xiaoling; CHENG Shaorong; LI Feng

doi:10.13730/j.issn.1009-2595.2018.01.008

Abstract：Objective To explore the imaging features of primary bone lymphoma (PBL),and improve the understanding and diagnostic ability of PBL.Methods Twelve cases with puncture or surgical pathology proved PBL were retrospectively analyzed by clinical features and imagings of X-rays,computerized tomography (CT) and magnetic resonance imaging (MRI).Results All 12 PBLs were non-Hodgkins lymphoma,of which 11 were large B-cell lymphoma,1 was follicular lymphoma,9 were single bone lesion,and 3 were multiple bone lesions.Focal lesions were located on limbs in 5 cases,vertebrae in 4 cases,other irregular bones in 3 cases.The X-rays and CT showed osteolytic lesions in 5 cases,sclerosis in 3 cases,mixed-type in 3 cases,negative X-ray and CT result in 1 case.Among them,1 case showed abnormal signal only by MRI,and another ease revealed local radioactive concentration by preoperative positron emission tomography computed tomography (PET-CT).In 12 PBL cases,soft tissue mass around the diseased bone was seen with common features of small bone destruction range and large soft tissue mass.Three cases had pathological fracture and 4 cases had periosteal reaction.One each case of osteomyelitis,myeloma,osteosarcoma were diagnosed preoperatively in 12 PBL cases.The misdiagnosis rate was 25.00％.Conclusion X-ray,CT and MRI can improve the diagnostic accuracy of PBL.PBL is a rare tumor.Clinical manifestations are lack of specificity.MRI sensitive shows early lesions.The combination of X-ray,CT and MRI can improve diagnostic accuracy of PBL.