Diffuse large B-cell lymphoma − secondary bone involvement
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2012, Vol 29, Issue 5
Abstract
22-year-old Albanian woman presented to our department with left axillary and supraclavicular lymphadenopathy of 6-month duration. She experienced also bone pain and soft tissue swelling of left femur and knee. Swelling was insidious in onset and gradually increased in size. No constitutional symptoms (fever, weight loss, night sweats) were reported. Her medical history and family history were not contributory. Physical examination revealed left axillary and left supraclavicular lymphadenopathy and painful, hard swelling of lower segment of the left femur. Overlying skin appeared slightly stretched. On palpation there was no local raise in temperature and the swelling was tender. Complete blood counts, erythrocyte sedimentation rate and CRP were normal. Serum biochemistry showed slightly elevated LDH levels (230 IU/L vs the upper normal limit of 220 IU/L). CT scan of the cervix and thorax revealed enlarged axillary and supraclavicular lymph nodes (up to 2.5 cm). CT of the abdomen was negative. A left knee X-ray was performed and showed a widened metaphysis of the femur and periosteal reaction (figures 1, 2). CT of the left knee revealed a lytic lesion that caused scalloping of the cortical region of the bone. Skeletal survey was otherwise normal. Tc-99m bone scanning revealed increased uptake on the lower segment of the left femur and [b]the lower segment of the humerus (figures 3, 4). Bone marrow aspiration and biopsy revealed only reactive changes. A left axillary lymph node biopsy was diagnostic.[/b]
Authors and Affiliations
G. GAINAROU, T. VASSILAKOPOULOS, E. KOUTSI, L. PAPAGEORGIOU, K. PETEVI, A. KANELLOPOULOS, P. FLEVARI, V. TELONIS, M. ANGELOPOULOU, J. MELETIS
Keywords
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