SA Orthopaedic Journal
On-line version ISSN 2309-8309
Print version ISSN 1681-150X
MAGAGULA, R et al. Osseous manifestations of non-Hodgkin's lymphoma in Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). SA orthop. j. [online]. 2015, vol.14, n.3, pp.18-23. ISSN 2309-8309. http://dx.doi.org/10.17159/2309-8309/2015/V14N3A1.
BACKGROUND: Lymphoma is the second most common Acquired Human Immunodeficiency Syndrome (AIDS)-associated neoplasm, the commonest being Kaposi sarcoma. The diagnosis and treatment of bone lymphoma still remains a challenge in our environment. MATERIALS AND METHODS: This is a retrospective chart review of 105 patients who were diagnosed histopathologi-cally with lymphoma involving the bone over a period of 11 years in six local hospitals. RESULTS: Forty-five (42.9%) patients with bone lesions and who were positive for Human Immunodeficiency Virus (HIV) formed the cohort. Clinical manifestations varied from swelling and pain in all patients to pathological fractures (n = 5, 11.1%) and paraplegia (n = 11, 24.4%) due to cord compression. Common sites included the spine, pelvis, femur, humerus, ribs, tibia and mandible. Treatment included chemotherapy and radiation, splinting or surgical fixation of pathological fractures and decompression of the spine with or without fusion. CONCLUSION: Bone lymphoma should be considered in any HIV-positive patient presenting with unexplained swelling and pain. The radiological picture may mimic bone infections like chronic pyogenic osteomyelitis, tuberculosis and fungal infections, other systemic disorders like Paget's disease, blood-related tumours such as leukaemia and other primary and metastatic bone neoplasms.
Keywords : bone lymphoma; non-Hodgkin's; HIV; AIDS.