Primer kemik lenfomalarının değerlendirilmesi ve pozitron emisyon tomografisinin önemi

Abstract

Kemiğin primer lenfoması, non-Hodgkin lenfoma veya Hodgkin lenfoma şeklinde, oldukça nadir görülen bir tümördür. Büyük kısmını non-Hodgkin lenfomanın oluşturduğu lenfomaların alt tipleri içerisinde en sık diffüz büyük hücreli lenfomaya rastlanır. Hastalar ağrı, şişlik veya patolojik kırık ile başvurabilirler. Kesin tanı biyopsi ile konulur. Tedavi kemoterapi, radyoterapi ve cerrahiden oluşan yaklaşım ile düzenlenir. Çalışmamızda ağrı ve şişlik nedeniyle başvuran 3 erkek olgu bildiriyoruz. Femur distali, fibula proksimali ve iliak kanat tutulum bölgelerini oluşturmakta idi. Histopatolojik olarak non-Hodgkin lenfoma tanısı aldıktan sonra tüm olgulara kemoterapi tedavisi uygulandı. Femur distal tutulumu olan olguya distal femur rezeksiyon protezi uygulandı. Fibula başı tutulumu olan olguda düşük ayak ve yara iyileşmesinde gecikme gözlendi. Flor-18-florodeoksiglikoz pozitron emisyon tomografisi/bilgisayarlı tomografi uygulanan tüm hastalar tedaviye tam yanıt verdi. Güncel takipteki olgular remisyonda ve okullarına devam etmektedirler.

Keywords

• Kemik; lenfoma; pozitron emisyon tomografisi

Evaluation of primary bone lymphoma and the importance of positron emission tomography

Abstract

Primary lymphoma of the bone is an extremely rare tumor in the form of non-Hodgkin lymphoma or Hodgkin lymphoma. The majority of primary bone lymphomas are non-Hodgkin lymphoma, of which the most common subtype is diffuse large cell lymphoma. Patients can present with pain, swelling or pathologic fracture. Definitive diagnosis is made after biopsy examination. Treatment consists of chemotherapy, radiotherapy and surgery. We report 3 male patients who presented with pain and swelling. Involvement was in the distal femur, proximal fibula and iliac crest in all patients. Patients were diagnosed with non-Hodgkin lymphoma in biopsy examination and underwent chemotherapy. The patient with distal femoral involvement underwent distal femoral resection prosthesis. Another patient with involvement of the fibular head experienced foot drop and delayed wound healing. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography revealed complete response to the treatment. Patients are in remission and continue schooling.

Keywords

• Bone
• lymphoma
• positron emission tomography

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