Lymphoma Presenting in Bone

Lymphoma presenting in bone (that is "reticulum cell sarcoma of bone") is a form of extranodal lymphoma historically described as frequently localized (that is, stage IE or stage IIE). Between 1970 and 1975, 14 patients with this entity were seen at the National Cancer Institute. This group had a variety of histologic subtypes of diffuse lymphoma. Thorough staging showed extensive disease (stage IV) in 12 of these patients (86%). In 10 of these the metastatic disease was unsuspected clinically. Seven patients achieved complete remissions after treatment with combination chemotherapy alone (two patients), irradiation alone (one patient), surgery alone (one patient), and both chemotherapy and irradiation (three patients) and are alive and free of disease 11 + to 70 + months after diagnosis. The other seven patients did not achieve complete remission status and have all died. Although lymphomas presenting in bone may occasionally be localized, careful staging in this series frequently showed extensive disease and altered the therapeutic approach.