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Journal of Case Reports
Primary Lymphoma of Long Bones causing Pathological Fracture: A Rare Entity
Swetabh Verma1, Saumitra Dwivedi1, Dharmendra Singh D1, Mohammad Zahid Khan1, Niti Singhal2 
Departments of 1Orthopaedics and 2Pathology, Bone and Joints Institute, Medanta, Lucknow, Uttar Pradesh, India.
Corresponding Author:
Dr Swetabh Verma
Email: swetabhverma26@gmail.com 
Received: 18-MAY-2020 Accepted: 19-AUG-2020 Published Online: 15-OCT-2020
DOI: http://dx.doi.org/10.17659/01.2020.0056
Background: Non-Hodgkin’s lymphoma ranks between 5th to 9th most common neoplasm worldwide, but the incidence of extra-nodal lymphoma is only between 3-5%. Gastrointestinal system is the most common site of such extra-nodal involvement, those arising from bone are still a rare occurrence. Case Report: We present atypical manifestation of diffuse large B cell lymphoma of right proximal femur in a 75 year old gentleman. He presented to the outpatients clinic with a history of gradually progressive swelling in right groin and thigh since five months. Radiographs of right hip and thigh showed intra-medullary implants in situ with near total destruction of trochanteric region. Contrast tomography scans of right hip and thigh showed a circumferential lesion from trochanter till mid-thigh involving all the compartments. The biopsy from the lesion revealed diffuse large B cell lymphoma. The patient received chemotherapy and is in follow up with satisfactory response. Conclusion: Diffuse B cell lymphomas can be a rare diagnosis beyond 6th decade and also present with pathological fractures with minimal constitutional symptoms and a slow growing mass. Strong clinical suspicion and prompt diagnosis can be useful in instituting an early chemotherapy.  
Keywords : Diffuse Large B-Cell Lymphoma, Femur, Imaging, Magnetic Resonance Imaging. Thigh.
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