Sirelkhatim A, Kaiserova E, Kolenova A, Puskacova J, Subova Z, Petrzalkova D, Banikova K, Suvada J, Sejnova D
Department of Pediatric Oncology, University Children's Hospital, Bratislava, Slovakia.
Bratisl Lek Listy. 2009;110(10):630-5.
The tumor formation may be the earliest manifestation preceeding other symptoms, signs and bone marrow evidence of systemic malignancy - leukemia/lymphoma. Here we present three cases of systemic malignancy in which bone lesions were the first manifested signs of the disease. All three cases were thought to be orthopedic cases and had been treated as so without genuing improvement. We would like to draw an attention to children who present with multifocal musculoskeletal pain and the importance of whole-body scaning. We describe interesting cases of diffuse large cell lymphoma and leukemia that initially presented as primary osteolytic bone lesion and discuss the differential diagnosis, literature review of non-Hodgkin's lymphoma arising in bone as the primary site (Tab. 1, Fig. 3, Ref. 18). Full Text (Free, PDF) www.bmj.sk.
肿瘤形成可能是全身性恶性肿瘤——白血病/淋巴瘤的其他症状、体征及骨髓证据出现之前的最早表现。在此，我们呈现三例全身性恶性肿瘤病例，其中骨病变是该疾病的首发体征。所有这三例最初都被认为是骨科病例并按此进行了治疗，但未见明显改善。我们想提醒关注出现多灶性肌肉骨骼疼痛的儿童以及全身扫描的重要性。我们描述了最初表现为原发性溶骨性骨病变的弥漫性大细胞淋巴瘤和白血病的有趣病例，并讨论了鉴别诊断，对以骨为原发部位的非霍奇金淋巴瘤进行了文献综述（表1，图3，参考文献18）。全文（免费，PDF）www.bmj.sk 。
