Spinal Bone Lymphoma

Bone lymphoma is a heterogeneous set of distinct clinicopathological entities with different disease stages and prognoses. It can be categorized into primary solitary lymphoma of bone, primary multifocal or polyostotic lymphoma of bone, and disseminated lymphoma with bone involvement. Primary lymphoma of bone is rare, and secondary bone lymphoma is more frequent. Spinal location is not uncommon and has the particularity of proximity to the central nervous system. Clinical presentation and imaging features are nonspecific. Open surgery biopsy is preferred for histological and immunohistochemical examination. MRI is the imaging modality of choice for local staging. 18F-FDG-PET/CT is the gold standard for distant staging. Whole-body MRI with diffusion-WI is an interesting alternative. Treatment is based on chemotherapy and radiotherapy. Surgical treatment is reserved for neurological complications and spinal instability. Primary lymphoma of bone has the best prognosis, whereas polyostotic and disseminated lymphomas have more variable reserved prognosis. The spinal location is associated with a worse outcome compared to the appendicular skeleton location.