Multifocal Primary Lymphoma of Bone: Scintigraphy and MR Findings Before and After Treatment

A case of multifocal primary lymphoma of bone is reviewed. Ga-67 citrate, Tc-99m HMDP, and Tl-201 scintigraphs all showed multifocal radiotracer accumulation. CT showed subtle osteolytic and osteosclerotic changes with surrounding soft tissue density mass. MRI clearly showed abnormal signal intensity in the bone marrow. After systemic chemotherapy and infield radiotherapy, the patient showed clinically complete remission. MRI showed reduction of the extraosseous components, but there was little signal change in the bone marrow despite the clinical response to the therapy. Scintigrams were more useful than MRI and CT for both staging and assessing the early response to therapy. The soluble interleukin-2 receptor level was found to be related to tumor cell activity.