Krishnan Anant, Shirkhoda Ali, Tehranzadeh Jamshid, Armin Ali R, Irwin Ronald, Les Kimberly
Department of Diagnostic Radiology, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USA.
Radiographics. 2003 Nov-Dec;23(6):1371-83; discussion 1384-7. doi: 10.1148/rg.236025056.
Primary bone lymphoma is an uncommon malignancy that accounts for less than 5% of all primary bone tumors. The radiographic appearances of primary bone lymphoma are variable, and, because the lesion can appear near normal on plain radiographs, a second modality such as bone scintigraphy or magnetic resonance (MR) imaging should be used. Despite this variability, the presence of a solitary, permeative, metadiaphyseal lesion with a layered periosteal reaction on plain radiographs and a soft-tissue mass on MR images, especially in a patient older than 30 years, is highly suggestive of lymphoma. The case for a diagnosis of primary bone lymphoma is further strengthened if the soft-tissue mass and marrow changes are associated with surprisingly little cortical destruction. Primary bone lymphoma has a better prognosis than many other malignant bone tumors; therefore, early identification allows for appropriate treatment. MR imaging not only permits early identification but also depicts the extent of soft-tissue involvement and can be used to assess the outcome of treatment.
原发性骨淋巴瘤是一种罕见的恶性肿瘤，占所有原发性骨肿瘤的比例不到5%。原发性骨淋巴瘤的影像学表现多样，由于病变在平片上可能看似正常，因此应使用骨闪烁显像或磁共振（MR）成像等第二种检查方式。尽管表现多样，但平片上出现孤立的、浸润性的、干骺端病变并伴有分层骨膜反应，且MR图像上有软组织肿块，特别是在年龄大于30岁的患者中，高度提示淋巴瘤。如果软组织肿块和骨髓改变伴有出人意料的轻微皮质破坏，则原发性骨淋巴瘤的诊断依据会进一步加强。原发性骨淋巴瘤的预后比许多其他恶性骨肿瘤要好；因此，早期识别有助于进行适当的治疗。MR成像不仅能实现早期识别，还能描绘软组织受累的范围，并可用于评估治疗效果。
