Abstract

Lymphoma of bone: a review of 140 patients

Author(s): Henry J Mankin, Francis J Hornicek, David C Harmon and Mark C Gebhardt

Background: Hodgkin’s and non-Hodgkin’s lymphoma commonly occur in patients in their middle years and are more frequent in males than in females. The cause of these entities is unknown, although infectious, immunologic and genetic origins have been postulated. Both diseases, and in particular, Hodgkin’s lymphoma, are rarely seen in the skeletal system and are generally thought to have a better prognosis when confined to bone. Methods: The authors have treated 140 patients with Hodgkin’s lymphoma (ten patients) and non-Hodgkin’s lymphoma (130 patients) since 1972 and report the results in this presentation. More males were affected than females and the mean age of the study group was 45 years. The majority of these patients were MusculoSkeletal Tumor Society (MSTS) Stage II and Ann Arbor Stage IE. The principal sites of tumor occurrence were the femur, pelvis, tibia, humerus, spine and shoulder. Most often, treatment consisted of intralesional surgery followed by radiation and chemotherapy and only 12 of the 140 patients had marginal or wide resective surgery. Results: Overall survival for the patients was 68% in the non-Hodgkin’s group (130 patients), but only 50% for those with Hodgkin’s disease (ten patients). In addition, MSTS Stage, date of presentation and anatomic site had a significant effect on survival. Conclusions: Lymphoma principally occurring in bone is a difficult problem, partly because there is a high degree of variation in the presentation and treatment protocols are highly variable and sometimes not effective.