原发性骨恶性淋巴瘤

目的 原发性骨恶性淋巴瘤少见，本文拟探讨其临床特点及治疗方法。方法 本组１３例，男１０例，女３例，年龄１７￣５６岁，平均４１．２岁。脊柱５例，骨盆２例，肱骨２例，股骨２例，胫骨１例，肩胛骨１例。疼痛为共同表现，脊柱病变者均有不同程度的神经受损症状。Ｘ线检查：５例脊柱病变中，３例呈溶骨必改变，２例成骨型，有４例合并椎间隙变窄，３例椎体楔形变。发生于四肢者，有４例为溶骨性改变，１例为成骨型表现，３例表

Primary Malignant Lymphoma of Bone

Objective To analyze the clinical manifestation and treatment for primary malignantlymphoma of bone. Methods Thirteen patients with the primary site of tumors (spine in 5, ilium in 2,humerus in 2, femur in 2, tibia in l and scapula in l ) were reviewed. The most often presenting symptom waspain. The patients with involved spine commonly had dysfunction of nerve or spinal cord. The abnormalities ofplain radiographs were classified as lytic in 3, sclerotic in 2, and for spine lytic in 4, sclerotic in 3, combi-nation in 3 for extremities. Histologically, all of these patients had diffuse non-Hodgkin lymphoma with Blymphocyte lymphoma in 9, T lymphocyte lymphoma in 4. Nine cases were treated with chemotherapy andirradiation, three cases were treated with chemotherapy only, and one case was treated with irradiation only.Three patients with spinal compression received spinal decompression, one received ilium resection, and onewith humerus pathological fracture received allograft. Results The follow-up range l to 19 years (average,6. 5 years) . Eight patients survive, one died of multiple metastases in the group of nine patients treated withchemotherapy and irradiation, in the group of three patients treated with chemotherapy only, one died of me-diastinum metastases, and one with relapse in soft tissue of low back and received re-resection. One patienttreated with radiation died of bone marrow metastases. Conclusion Primary malignant lymphoma of bone issensitive to chemotherapy and irradiation, the prognosis was satisfactory when treated with a combination ofchemotherapy and irradiation.