Etiological, Clinical, Diagnostic, and Treatment Particularities of Primary Aggressive Bone Lymphoma

Primary bone lymphoma (PBL) is a neoplasm of malignant lymphoid cells that presents with one or more bone lesions without nodal or extranodal involvement. It accounts for approximately 7% of primary malignant bone tumors and can occur at any age, although it is most frequently diagnosed between 45 and 60 years, with a slight male predominance. The etiology of PBL remains unclear; however, several factors have been implicated in its development, including hereditary exostoses, AIDS, sarcoidosis, trauma, and bacterial or viral infections. The predominant histological subtype is diffuse large B-cell lymphoma. Most patients are diagnosed at stage IV, as the clinical presentation of PBL is generally nonspecific, often leading to delayed diagnosis. The most common symptom is localized bone pain in the affected area. Diagnosis requires a combination of histopathological and immunohistochemical examination. The treatment of PBL is based on systemic therapy, with current approaches including chemotherapy or immunochemotherapy with or without radiotherapy. Overall, PBL carries a generally favorable prognosis.