A CASE OF PRIMARY BONE LYMPHOMA ASSOCIATED WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME

A 33-year old man with acquired immunodeficiency syndrome war; admitte d to Severance hospital following 1 year of diarrhea and 2 to 3 months of low sternal pain. The patient had progressive generalized lymphade nopathy for the previous 3 years. Whole body bone scan for evaluation of bone pain showed multiple abnormal hot uptakes at the low sternal b ody and T8 and TIO vertebra. Chest CT showed multifocal cortical erosi on of the bone with soft tissue mass at the low sternal body and spine MRI showed multiple low-signal density in T1WI and high-signal densit y in T2WI at the T8 and TIO vertebral body. Biopsy war; performed at t he sternochondral junction and it showed high-grade malignant lymphoma of the large cell immunoblastic type. Immunostaining showed positive for the B-cell markers (CD79a and L26) and negative for the T-cell mar ker (UCHL1). Radiotherapy of 3,000 cGy was delivered to the sternum an d vertebra. Since then, systemic chemotherapy with m-BACOD regimen (ex cept dexamethasone) and anti-retroviral therapy with a combination of 3 drugs (didanosine, lamivudine, indinavir) has been performed. This i s the first case report of primary bone lymphoma associated with acqui red immunodeficiency syndrome in Korea.