Xu Yi-Wen, Duan Ming-Hui
Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China.
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China.
Oncol Lett. 2018 Feb;15(2):2529-2533. doi: 10.3892/ol.2017.7538. Epub 2017 Dec 6.
Bone marrow lymphoma with the onset of an isolated mass in the bone marrow is extremely rare. The present case report described a unique case of B cell lymphoblastic lymphoma (LBL) presenting with an isolated mass in the bone marrow cavity, without any organopathy or lymphadenopathy. An isolated mass in bone marrow is a rare primary manifestation of LBL. The patient in the present case report presented with pain in the right elbow, a fever, pancytopenia and splenomegaly. Additionally, no abnormality was determined in the lymph nodes, the bone marrow karyotype or a computed tomography scan of the humerus. Positron emission tomography (PET) examination revealed an increased uptake of F-fluorodeoxyglucose in right distal humerus. An isolated mass in the bone marrow cavity was removed by surgery. Pathological findings revealed B cell LBL. The patient received an acute lymphocytic leukemia chemotherapy regimen and achieved complete remission. However, 4 months following the initial diagnosis, the patient succumbed due to a relapse. The present case highlighted the importance of PET examination and biopsy, and the requirement to identify appropriate treatments for LBL. Additionally, it is important to broaden the differential diagnosis when an isolated mass is identified in the bone marrow cavity.
以骨髓孤立性肿块起病的骨髓淋巴瘤极为罕见。本病例报告描述了一例独特的B细胞淋巴母细胞淋巴瘤（LBL），其表现为骨髓腔内孤立性肿块，无任何器官病变或淋巴结病。骨髓孤立性肿块是LBL罕见的主要表现形式。本病例报告中的患者表现为右肘疼痛、发热、全血细胞减少和脾肿大。此外，在淋巴结、骨髓核型或肱骨计算机断层扫描中未发现异常。正电子发射断层扫描（PET）检查显示右肱骨远端F-氟脱氧葡萄糖摄取增加。通过手术切除了骨髓腔内的孤立性肿块。病理结果显示为B细胞LBL。患者接受了急性淋巴细胞白血病化疗方案并实现完全缓解。然而，在初次诊断4个月后，患者因复发死亡。本病例突出了PET检查和活检的重要性，以及确定LBL合适治疗方法的必要性。此外，当在骨髓腔内发现孤立性肿块时，扩大鉴别诊断范围很重要。
