RADIOLOŠKI PRIKAZ PRIMARNOG LIMFOMA KOSTI – RETROSPEKTIVNA STUDIJA

KRISTINA POTOČKI, MAJA PRUTKI, MARKO KRALIK, IVO RADMAN, RANKO SMILJANIĆ, RANKA ŠTERN-PADOVAN

U radu smo retrospektivno analizirali radiološki prikaz primarnog limfoma kosti u 13 bolesnika (šest muškaraca i sedam žena; srednja dob 30.6 godina) u razdoblju od 1994. do 2006. godine. Analizirani su radioloških prikazi kon­vencionalnom radiografijom, kompjutoriziranom tomografijom (CT), magnetskom rezonancijom (MR) i scintigrafijom. Litično-sklerotični uzorak primarnog limfoma kosti bio je zabilježen u 26 od 36 lezija na konvencionalnoj radiografiji i u 27 od 33 lezije na CT-u. Na MR-u lezije su bile homogene i hipointenzivne na TI, a heterogene i hipointenzivne, izointenzivne ili hiperintenzivne u odnosu na masno tkivo na T2-mjerenim prikazima. Scintigrafija kosti pokazala je žarišta povećanog nakupljanja u šest od osam bolesnika. Najveći broj lezija nalazio se u kostima zdjelice. Patohistološkom analizom ustanov­ljeno jeli ne-Hodgkinovih limfoma i dvije Hodgkinove bolesti. Primarni limfom kosti prikazuje se radiološki kao litično-sklerotična lezija, koja može zahvatiti meka tkiva i uzrokovati promjene u koštanoj srži povezane s relativno oskud­nom koštanom destrukcijom.

Summary. The purpose of our study was to retrospectively review imaging appearances of primary bone lymphoma in 13 patients (six males, seven females; mean age 30.6 years) from 1994 to 2006 on plain radiography, computed tomography (CT), magnetic resonance (MR) and scintigraphy. Lytic-sclerotic pattern was noticed in 26 of 36 bone lesions on plain radiography and in 27 of 33 lesions on CT scanning. On MR, lesions were homogeneous and hypointense on T1 weighted images, and inhomogeneous and hypointense, isointense or hyperintense with respect to fat on T2 weighted images. Increased uptake on bone scintigraphy was noticed in six out of eight patients. The most common location of primary bone lymphoma was the pelvis. Pathologic type was non-Hodgkin’s lymphoma in 11 patients and Hodgkin’s disease in two patients. Primary bone lymphoma presents as mixed lytic-sclerotic lesions that might cause the soft-tissue mass and bone marrow changes associated with little cortical destruction.