PMC8079212_01
Plain film reveals osteolytic metastases in the left humerus.
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fig1
A 12-year-old girl (no puberty) presented with localized pain of the left shoulder evolving for 9 months, and plain radiography done in the emergency showed osteolytic lesions without rupture of the cortex of the upper end of the left humerus (Figure 1) confirmed on computerized tomography (CT) scan.
Contrast-enhanced CT shows a heterogeneous density abdomino-pelvic tumor.
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fig2
Abdominal CT scan revealed a 10-cm diameter abdomino-pelvic mass of heterogeneous density without calcification (Figure 2), whose origin is difficult to assess.
Cytology of pediatric ovarian lymphoma: diffuse large B-cell lymphoma (40x).
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fig3
Immunohistochemistry indicated that the cells were positive for CD20 and CD45 and Ki67 (about 80%) but negative for CD3, BCL2, and BCL6 (Figures 3 and 4).
CD45 staining of the tumor cells (40x).
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fig4
Immunohistochemistry indicated that the cells were positive for CD20 and CD45 and Ki67 (about 80%) but negative for CD3, BCL2, and BCL6 (Figures 3 and 4).
Skeletal scintigraphy showing multiple bone metastases.
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fig5
The diagnosis made was a diffuse large B-cell lymphoma (DLBCL) of the left ovary with bone metastasis confirmed by bone scintigraphy which revealed multiple lesions with intensive radioactive accumulation in the left humerus, point of the left scapula, upper third of the left femur, the skull, and the second dorsal vertebra (Figure 5).