TY - JOUR
T1 - Pathological fracture due to primary bone lymphoma in a patient with a history of prostate cancer
T2 - A case report and review of literature
AU - Bhakta, Pooja
AU - Hunzeker, Zachary E.
AU - Garcia, Juan D.
AU - Youssef, Ayman
AU - Grant, Bradley J.
AU - Alfattal, Rasha
AU - Weaver, Dylan
AU - Bhargava, Peeyush
AU - Rischall, Ariel
AU - Musunuru, Tejo
AU - Muthukumarana, Palawinnage V.
AU - Mallick, Jayati
AU - Lyapichev, Kirill
N1 - Publisher Copyright:
Copyright © 2023 Bhakta, Hunzeker, Garcia, Youssef, Grant, Alfattal, Weaver, Bhargava, Rischall, Musunuru, Muthukumarana, Mallick and Lyapichev.
PY - 2023
Y1 - 2023
N2 - Primary bone lymphoma (PBL) is a rare extranodal presentation within lymphomas and primary bone malignancies. Pathologic fracture (PF) is a common complication of metastatic bone disease but is, rarely, the presentation of a primary bone tumor. We report a case of an 83-year-old man with a history of untreated prostate cancer, presenting with atraumatic fracture of his left femur after months of intermittent pains and weight loss. Radiographic workup revealed a lytic lesion suspicious for PF secondary to metastatic prostate cancer; however, initial core biopsy results were inconclusive for malignancy. A complete blood count with differential and complete metabolic panel was within normal limits. During surgical fixation and nailing of the femur, a reaming biopsy was performed as a repeat measure and revealed diffuse large B-cell lymphoma. Staging with positron emission tomography and computed tomography found no evidence of lymphatic or visceral involvement and chemotherapy was promptly initiated. This case highlights the diagnostic workup challenges for PF secondary to PBL, especially in the setting of concurrent malignancy. Because of the non-specific presentation of a lytic lesion on imaging associated with atraumatic fracture, we highlight PBL as an important diagnostic consideration.
AB - Primary bone lymphoma (PBL) is a rare extranodal presentation within lymphomas and primary bone malignancies. Pathologic fracture (PF) is a common complication of metastatic bone disease but is, rarely, the presentation of a primary bone tumor. We report a case of an 83-year-old man with a history of untreated prostate cancer, presenting with atraumatic fracture of his left femur after months of intermittent pains and weight loss. Radiographic workup revealed a lytic lesion suspicious for PF secondary to metastatic prostate cancer; however, initial core biopsy results were inconclusive for malignancy. A complete blood count with differential and complete metabolic panel was within normal limits. During surgical fixation and nailing of the femur, a reaming biopsy was performed as a repeat measure and revealed diffuse large B-cell lymphoma. Staging with positron emission tomography and computed tomography found no evidence of lymphatic or visceral involvement and chemotherapy was promptly initiated. This case highlights the diagnostic workup challenges for PF secondary to PBL, especially in the setting of concurrent malignancy. Because of the non-specific presentation of a lytic lesion on imaging associated with atraumatic fracture, we highlight PBL as an important diagnostic consideration.
KW - CHOP
KW - diaphyseal fracture
KW - diffuse large B cell lymphoma (DLBCL)
KW - femur
KW - pathological fracture
KW - primary bone lymphoma
KW - rituximab
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U2 - 10.3389/fonc.2023.1100559
DO - 10.3389/fonc.2023.1100559
M3 - Article
AN - SCOPUS:85152022908
SN - 2234-943X
VL - 13
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1100559
ER -