Rapoport A P, Constine L S, Packman C H, Rosier R N, O'Keefe R, Hicks D G, Rubin S J, Rowe J M
Department of Medicine, University of Rochester School of Medicine and Dentistry, New York 14642, USA.
Am J Hematol. 1998 May;58(1):1-7. doi: 10.1002/(sici)1096-8652(199805)58:1<1::aid-ajh1>3.0.co;2-x.
Primary bone involvement is an unusual extranodal presentation of non-Hodgkin lymphoma (NHL). The optimal treatment for this entity has not been determined. While solitary bone lymphomas can be eradicated with local radiation in 50% of patients, distant relapses occur frequently, and the treatment of patients with multifocal osseous disease, or those presenting with associated soft tissue invasion or adenopathy is even less satisfactory. Over a 4-year period, nine patients with multifocal bone lymphoma were treated with intensified versions of the ProMACE-CytaBOM regimen and involved-field radiation. Seven patients had diffuse large cell histology and two patients had diffuse mixed type. Seven patients survived event-free at a median follow-up of 2.3 years (range .5-3.5). In most survivors, there was little or no change in the abnormal radiographic bone findings despite the clinical response to therapy. In one patient, magnetic resonance imaging (MRI) established that bone infarction rather than relapse of lymphoma was the cause of a new lytic bone lesion that developed during treatment.
原发性骨受累是非霍奇金淋巴瘤（NHL）一种不常见的结外表现形式。该疾病实体的最佳治疗方案尚未确定。虽然50%的孤立性骨淋巴瘤患者可通过局部放疗根除，但远处复发频繁发生，对于多灶性骨病患者或伴有软组织侵犯或淋巴结病的患者，治疗效果更不理想。在4年期间，9例多灶性骨淋巴瘤患者接受了强化版的ProMACE-CytaBOM方案及受累野放疗。7例患者为弥漫大细胞组织学类型，2例为弥漫混合型。7例患者在中位随访2.3年（范围0.5 - 3.5年）时无事件生存。在大多数幸存者中，尽管对治疗有临床反应，但异常的骨影像学表现几乎没有变化或没有变化。在1例患者中，磁共振成像（MRI）确定骨梗死而非淋巴瘤复发是治疗期间出现的新溶骨性骨病变的原因。
