This is case which was previously MRI to be infective, ATT started and no response was noted and lesions increased subesequently. It was not thought to be AVN as head has not collapsed. Acetabulum is normal. There is fluid along with soft tissue invasion and no periosteal response. All point to primary bone lymphoma -femur common site
Primary bone lymphoma is defined as a tumor involving a single focus with unequivocal evidence of lymphoma in the bone lesion. It is rare. Most cases are of the diffuse large B-cell category. The age distribution is bimodal with peaks in the second to third decade, and a second peak in the fifth to sixth decade with women more commonly affected in the older age group. There is a wide pattern of bone involvement with the spine forming the most frequent site of axial lesions, and the femur is the most common site overall.
Primary bone lymphoma is defined as a tumor involving a single focus with unequivocal evidence of lymphoma in the bone lesion. It is rare. Most cases are of the diffuse large B-cell category. The age distribution is bimodal with peaks in the second to third decade, and a second peak in the fifth to sixth decade with women more commonly affected in the older age group. There is a wide pattern of bone involvement with the spine forming the most frequent site of axial lesions, and the femur is the most common site overall.
Further reading
Appl Radiol 33(3):36-44, 2004.
Case by Dr MGK Murthy, Sr Consultant Radiologist
&
Dr.Sumer K Sethi, MD, Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences
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