Secondary involvement of the bone with lymphoma

Secondary involvement of the bone with lymphoma, also referred as secondary bone lymphoma, is much more common than primary bone lymphoma, occurring in ~15% of disseminated lymphomas.

Terminology

Secondary bone lymphoma is defined as lymphoma involving the bone with nodal disease occurring within six months or secondary lymphoma involving the bone at least six months after diagnosis.

Epidemiology

Secondary bone involvement is more common in children (25%) ¹. 

Clinical presentation

Bone pain and/or pathological fracture

Pathology

Secondary bone involvement can result from direct spread from nodal disease or haematogenous metastases. The axial skeleton is more often affected than the appendicular skeleton ². The most frequent locations are ^1,3:

• spine
• bony pelvis
• skull
• ribs
• facial bones

Radiographic features

Plain radiograph / CT

• lytic lesion(s)
• permeative bone destruction with cortical breach
• adjacent soft tissue mass(es)