Jadidi Jami, Behzadi Fardad, Sighary Maziar, Alshal Mohamed, Kolla Srinivas, Lehto Scott A
Department of Pathology, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203, USA.
Department of Radiology, Brigham Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
Radiol Case Rep. 2019 Oct 31;14(12):1561-1565. doi: 10.1016/j.radcr.2019.09.015. eCollection 2019 Dec.
Primary bone lymphoma (PBL) is rare bone disease that accounts for very small number of all primary bone tumors. Among the described sites of PBLs, the patella is an extremely rare example To date, only a few cases of PBL affecting the patella have been reported. Clinically, these tumors have very similar presentation of pain, decreased range of motion and swelling and, sometimes, pathologic fractures. On radiographs, skeletal lymphoma commonly manifests as osteolytic lesions with ill-defined margins affecting the metaphysis of axial long bones. We present a rare case of patellar adult T-cell lymphoma/leukemia in a 58-year-old female who presented with left-knee pain and swelling. Computed tomography and magnetic resonance imaging revealed diffuse marrow replacement by a lesion with aggressive features. PET scan demonstrated neoplastic range hypermetabolic FDG uptake within this lesion. Ultrasound-guided biopsy was consistent with PBL.
原发性骨淋巴瘤（PBL）是一种罕见的骨疾病，在所有原发性骨肿瘤中占比极少。在已描述的PBL发病部位中，髌骨是极为罕见的一例。迄今为止，仅有少数累及髌骨的PBL病例被报道。临床上，这些肿瘤的表现非常相似，均有疼痛、活动范围减小和肿胀，有时还会出现病理性骨折。在X线片上，骨骼淋巴瘤通常表现为边界不清的溶骨性病变，累及轴向长骨的干骺端。我们报告了一例罕见的58岁女性髌骨成人T细胞淋巴瘤/白血病病例，该患者表现为左膝疼痛和肿胀。计算机断层扫描和磁共振成像显示病变呈侵袭性特征，弥漫性骨髓替代。PET扫描显示该病变内肿瘤区域有高代谢的FDG摄取。超声引导下活检结果与PBL一致。
