$pathological fracture cancer$

$pathological fracture cancer$

On the basis of the available data, the average age of diagnosis is 45–60 years old with a slight predominance toward male patients ( 4).Īpproximately 95% of diagnosed PBL is pathologically characterized as diffuse large B-cell lymphoma (PB-DLBCL) ( 4, 6, 7). Given its rarity, it has been difficult to employ a consistent definition and to fully understand the clinical and pathologic characteristics of this unique entity ( 5). However, PBL accounts for less than 1% of all lymphomas and less than 5% of all primary bone tumors ( 3, 4). Originally termed “reticulum sarcoma of the bone” nearly a century ago, primary bone lymphoma (PBL) began to officially be histologically and cytologically recognized in the 1970s ( 2). The 2020 World Health Organization classification of tumors of bone classifies primary non-Hodgkin lymphoma of the bone as a neoplasm of malignant lymphoid cells in the bone with no lymph node involvement or other extranodal involvement ( 1). Because of the non-specific presentation of a lytic lesion on imaging associated with atraumatic fracture, we highlight PBL as an important diagnostic consideration. This case highlights the diagnostic workup challenges for PF secondary to PBL, especially in the setting of concurrent malignancy. Staging with positron emission tomography and computed tomography found no evidence of lymphatic or visceral involvement and chemotherapy was promptly initiated. During surgical fixation and nailing of the femur, a reaming biopsy was performed as a repeat measure and revealed diffuse large B-cell lymphoma. A complete blood count with differential and complete metabolic panel was within normal limits. Radiographic workup revealed a lytic lesion suspicious for PF secondary to metastatic prostate cancer however, initial core biopsy results were inconclusive for malignancy. 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. Pathologic fracture (PF) is a common complication of metastatic bone disease but is, rarely, the presentation of a primary bone tumor.

$pathological fracture cancer$

Primary bone lymphoma (PBL) is a rare extranodal presentation within lymphomas and primary bone malignancies.

$pathological fracture cancer$

5Division of Hematology and Oncology, Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

4Department of Radiology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

3Department of Pathology, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

2John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

1Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, United States.

Muthukumarana 3, Jayati Mallick 3 and Kirill A. Grant 3, Rasha Alfattal 3, Dylan Weaver 4, Peeyush Bhargava 4, Ariel Rischall 5, Tejo Musunuru 5, Palawinnage V.

$pathological fracture cancer$

Pathological fracture cancer