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Clinical features and treatment of primary skeletal lymphoma

YANG Zuozhang, XU Jianbo, XIE Lin, et al. Department of Orthopaedics, Yunnan Province Tumor Hospital, Kungming 650118,China  
Objective To explore clinical features and treatment outcome of primary skeletal lymphoma. Methods 11 primary skeletal lymphoma cases who admitted from April 1995 to October 2003 were studied retrospectively. The histological diagnose was reconfirmed. The primary sites are ilium(3) and thoracic (2) and lumbar (2) and cranium (1) and ulna (1) and femur(1). The most often presenting symptom was pain. The lumbar lymphoma had nervous dysfunction. X-ray showed osteolysis and erosion of the bone. Most of histological types were diffuse B-cell lymphoma. Local radiotherapy combined with chemotherapy was conducted. The lumbar patient with pathological fracture and received percutaneous vertebroplasty and one hip patient had local resection and prosthesis replacement. Results The follow-up ranges from one to eight years and the average is 2.5 years. The 1-year ,3- years and 5-years survival rates were 100%(11/11),66.7%(2/3) and 50.0%(1/2) respectively. The lumbar lymphoma patient died of mediastinum metastasis. The survival rates decreased with the progression of the clinical stages. Conclusions Primary skeletal lymphoma is a rare malignant bone tumor. Combination therapy including radiotherapy and chemotherapy are the main treatment and surgery is an adjuvant procedure to treat or prevent pathologic fractures.
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