Primary lymphoma of bone, myeloma mimicker: a case report and review of literature

Primary lymphoma of bone, myeloma mimicker: a case report and review of literature

Deena Mudawi1, Samah Kohla2,3, Feryal Ibrahim2, Hesham Elsabah1, Mohamed Abdelrazek4, Lajos Szabados5, Mohammad A Abdulla1, Omar M Ismail1, Abdulqadir J Nashwan1 And Mohamed A Yassin1

1Department of Medical Oncology, Hematology Section, National Center for Cancer Care and Research, Doha, Qatar; 2Lab Medicine and Pathology Department, Hematology Section, Hamad Medical Corporation, Doha, Qatar; 3Clinical Pathology Department, Hematology Section, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 4Department of Radiology, Hamad Medical Corporation; 5PET/CT Center, Clinical Imaging, National Center for Cancer Care and Research, Doha, Qatar

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Primary lymphoma of the bone (PLB) primarily arising from the medullary cavity is an extremely rare entity, with only limited number of studies and sporadic cases reported in the literature. The current study presents one case of PLB presented with unique presentation and treated with chemotherapy only. A 66 year old male presented with severe pain in the left hip that persisted for two months. Initial laboratory work up showed anemia, hypercalcemia and increase in free light chains kappa to lambda ratio, a diagnosis of multiple myeloma was suspected, magnetic resonance imaging of the vertebral spine extensive involvement of bone marrow of the vertebrae.
An 18F fluorodeoxyglucose positron emission tomography computed tomography (FDG PET CT) scan showed widely scattered moderate to intense uptake in multiple lytic of skeleton, Impression was : Image compatible with extensive multiple myeloma, No extra osseous involvement was found.
Bone marrow examination was performed confirmed a diagnosis of extensive bone marrow involvement by High grade B-cell neoplasm with areas of bone marrow necrosis.
The patient received six cycles of R-CHOP regimen (Rituximab, cyclophosphamide, Anthracycline, vincristine and prednisone) and achieved a complete response, as confirmed by FDG PET CT. At present, the patient is in a good this patient presentation mimicking multiple myeloma, which represent diagnostic dilemma.
Primary lymphoma of the bone is rare disease entity, there is no strong evidence supporting some diagnostic and therapeutic decisions, and therefore, case presentation of the rare disease may facilitate treatment of similar diseases. A review of the literature to elucidate the clinical, radiological, pathological phenotype and optimal treatment of PLB done.

Keywords: Primary lymphoma of the bone, extra nodal, high grade B-cell lymphoma, multi focal lesions

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How to cite this article:
Deena Mudawi, Samah Kohla, Feryal Ibrahim, Hesham Elsabah, Mohamed Abdelrazek, Lajos Szabados, Mohammad A Abdulla, Omar M Ismail, Abdulqadir J Nashwan, Mohamed A Yassin. Primary lymphoma of bone, myeloma mimicker: A case report and review of literature. International Journal of Case Reports, 2018 3:55. DOI:10.28933/ijcr-2018-12-0108


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