Findings: A single AP view of the right shoulder demonstrates a permeative lesion throughout the right humerus involving the proximal metaphysis and extending throughout the diaphysis. A pathologic fracture is seen through the proximal humeral diaphysis. A soft tissue component is not visualized.

Diagnosis: Lymphoma.

Discussion: Lymphoma can be divided into non-Hodgkin's lymphoma and Hodgkin's disease. Skeletal involvement can be seen in approximately ¼ of patients. Primary lymphoma of bone occurs in approximately 5% of patients.

Radiographic findings include multiple osteolytic lesions with a permeative appearance.

The differential diagnosis of a permeative lesion can be organized by age group. Neuroblastoma can be seen in infants. In addition, eosinophilic granuloma, leukemia and lymphoma can be seen in children. Lymphoma, multiple myeloma and metastatic disease can be seen in adults.

Reference:
Resnick D, Haghighi P. Bone and Joint Imaging, 2nd Edition.
W. B. Saunders, Philadelphia; 1996:629-632.

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