Non-Hodgkin Lymphoma Involving the Bone (NHLB): Report of Ten Cases.

Background: NHLB is an unusual entity. Primary NHL of the bone comprising approximately 5–12 % of all bone cancer and less than 12% of all extra-nodal lymphomas; surgery resection does not have a therapeutic role and diagnosis is usually established by bone biopsy.

Aim of the study: To demonstrate the clinical features of bone lesion in order to optimize diagnostic approaches and to evaluate prognostic factors and treatment.

Patients and Methods: Ten pts with NHLB were diagnosed with surgical bone biopsy in the last 5 years. Pain and soft tissue swelling were the commonest symptoms. Two pts showed a unique bone lesion which was classified as primary lymphoma of the bone (PLB). In 8 cases, dissemination of the disease with multiple bone and/or visceral involvement was apparent (dNHL). The characteristics of pts were: median age 58,4 years (range 39–82 yrs), male: 70%; female: 30%; CS I, 20%, and CS IV, 80%, BM+ vs BM− (20% vs 80%); IPI was: low, 0–2, in 50%, vs high, 3–5 in 50%; bulky disease in 20%. All pts had B-phenotype; DLBCL in 8 pts, lymphoplasmocitoid lymphoma in 1 pt and follicular lymphoma, grading 2, in 1 pt, according to REAL-classification. Nine pts received CT with CHOP- like regimens (6 courses) to be repeated every 2 or 3 weeks. Only one pt received HDT with PBSCT. Three pts received CT + local irradiation (30 Gy).

Results: CR was achieved in 80% of cases; all these pts were alive and disease free. Only the pt with unique bone lesion and lymphoplasmocitoid features, received only surgery therapy and is alive and disease free. Two pts died for PD at +1 and +6 months at initial sites of disease. Median OS was 19.6 months (range 1–62) and DFS was 20 months (range 2–58).

Conclusions: The long-term survival of these pts is favourable but dependent on histology and clinical stage and appears to parallel that of pts with lymphoma of similar histology involving other sites.