SOLITARY SKELETAL LESIONS AS PRIMARY MANIFESTATIONS OF NON-HODGKINS-LYMPHOMA - REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

Two patients with solitary skeletal lesions of the lower extremity wer e eventually diagnosed as having high-grade malignant B-cell non-Hodgk in's lymphoma. In both cases staging revealed no other nodal or extran odal involvement. One patient had been symptomatic for more than 2 yea rs, presenting originally as a case of chronic synovitis. The second p atient presented with slight exertional pain in his left knee of relat ively recent history. In his case the initial plain X-ray showed littl e evidence of bony destruction, while magnetic resonance imaging revea led an extensive lesion in the left tibial plateau. Orthopedic surgeon s should be aware of the differential diagnosis of primary lymphoma of bone. Early use of magnetic resonance imaging, in addition to plain X -ray and scintigraphic imaging, can be helpful in leading to an early biopsy and consequently early treatment. Magnetic resonance imaging sh ould be regarded as the method of choice for follow-up examinations of lymphoma lesions.