Primary bone lymphoma in children: <br /> diagnostic difficulties
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2004, Vol 6, Issue 4
Abstract
Background. Primary localization of non-Hodgkins lymphoma (NHL) in the skeletal system is very rare in children. Bone tissue involvement most often points to metastasis from a primary focus localized elsewhere. The atypical localization and histopathological classification problems cause diagnostic difficulties, which delays the implementation of treatment until the children have reached a higher clinical stage (III or IV), leading to a poor prognosis.Case descriptions. We present 12 cases of pediatric NHL with primary localization in the skeleton (9 boys, 3 girls). In 10 of these cases only the skeletal system was involved, while in 2 cases there was simultaneous lymph node involvement. The average time from onset to correct diagnosis was 1.5 months. Initially these patients were diagnosed provisionally with localized or diffuse neoplasm of the bone. Of the 8 children in whom the diagnostic process lasted longer than 2 months, 7 died despite intensive treatment (BFM 86, LMB 89, ICE). One boy, additional treated with anti-CD20 and RT, is still alive and has been symptom-free for 4 months.Conclusions. Difficulties in histopathological diagnosis result not only from the crush effect, but also from the morphological picture, often differing from NHL, and sometimes resembling neoplastic or neuroectodermal tumors. The co-expression of neural or neuroendocrine markers can also be misleading. Given the ambiguous morphology, CD20 staining should be standard practice. In cases of local or dispersed skeletal pain one should also consider the possibility of neoplastic growth from the lymphatic system. The drugs now available seem to improve prognosis.
Authors and Affiliations
A. Raciborska, W. Wożniak, M. Rychłowska, J. Małdyk , B. Sopyło, T. Klepacka, J. Peregud-Pogorzelski
Keywords
Related Articles
- EP ID EP56215
- DOI -
- Views 134
- Downloads 0
Próba wykorzystania termografii do monitorowania regeneratu kostnego w czasie wydłużania kończyn – doniesienie wstępne
Wstęp. Rutynowo ocenę regeneratu kostnego dokonuje się na podstawie zdjęć rentgenowskich wykonywanych co 7 14 dni w okresie dystrakcji i co 14 28 dni w okresie stabilizacji. Z procesem regeneracji tkanek, występujący...
The Use of Neurodynamic Techniques in the Conservative Treatment of Carpal Tunnel Syndrome – a Critical Appraisal of the Literature
Background. Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy, characterized by the presence of many sensory and motor abnormalities. In the physiotherapy of patients with CTS, neurodynamic technique...
Ocena satysfakcji pacjentów z leczenia skoliozy idiopatycznej gorsetem piersiowo-lędźwiowym
Wstęp. Najskuteczniejszą nieoperacyjną metodą leczenia skolioz idiopatycznych w przedziale 25°-45° skrzywienia według Cobba jest leczenie za pomocą gorsetów ortopedycznych. Celem pracy było sprawdzenie przestrzegania zal...
Biodynamic method for 3-D correction of idiopathic scoliosis: a description of the method
The biodynamic method of three-dimensional correction of idiopathic scoliosis is based on the pathomechanics of idiopathic scoliosis, and consists in active, segmental, three-dimensional correction of spinal curvature. T...
Influence of various forms of physical exercise on bioelectric activity of quadriceps femoris muscle – pilot study.
SummaryIntroduction: Recent years have seen a dynamic development of treatment methods targeting the knee joint region. Surgical interventions are becoming increasingly less invasive, being at the same time ever more div...