Increasing incidence of musculoskeletal lymphoma diagnosed via orthopedic consultation: A 17-year retrospective study

This study aimed to investigate the clinical characteristics of patients diagnosed with malignant lymphoma at the Kanazawa University Department of Orthopedic Surgery between 2007 and 2024. Clinical data were retrospectively collected, including sex, age, histology, localization at initial consultation, pain, B symptoms, number of lesions, magnetic resonance imaging signal characteristics, and levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), soluble interleukin-2 (sIL-2) receptor, and maximum standardized uptake values (SUVmax) from positron emission tomography-computed tomography. Statistical analyses were conducted to evaluate the correlations between clinical variables and pain, B symptoms, lesion multiplicity, sIL-2 receptor level, and SUVmax. Overall, 71 patients (men: 35, women: 36; median age: 68 [range: 18–92] years) were included. Of these, 31 presented with bone tumors, and 40 had soft tissue tumors. Twenty-one cases were diagnosed from 2007 to 2015, and 50 between 2016 and 2024. The main sites of bone lymphoma at initial presentation were the spine (n = 11) and pelvis (n = 11); for soft tissue lymphomas, the thigh (n = 10), upper arm (n = 6), and groin (n = 6) were the main sites. MRI signal changes were predominantly T1 isointense and T2 hyperintense for both bone and soft tissue lymphomas. Pain was significantly associated with bone lymphoma ( p < 0.01) and CRP level ≥1 mg/dL ( p < 0.05). B symptoms were also associated with CRP ≥1 mg/dL ( p < 0.05). Elevated sIL-2 receptor levels were significantly associated with LDH levels ≥400 U/L ( p < 0.05). The prevalence of malignant lymphomas increased with time, corresponding to an increase in cases diagnosed at orthopedic consultations. • Increase in musculoskeletal lymphoma cases diagnosed via orthopedic consultations. • Diffuse large B-cell lymphoma was the most frequent histology in both bone and soft tissue. • Pain was linked to bone lymphoma and elevated CRP levels. • B symptoms were associated with CRP ≥1 mg/dL. • Elevated sIL-2 receptor correlated with elevated LDH levels.