Infected Primary Bone Mantle Cell Lymphoma with Multiple Vertebral Involvement

Rebeh  Bougossa; Fatma  Larbi; Asma Ben  Mabrouk; Olfa  Jomaa; Jihene  Chelli

doi:10.18502/ijhoscr.v18i4.16765

Rebeh Bougossa Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, Tunisia
Fatma Larbi Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, Tunisia
Asma Ben Mabrouk Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, Tunisia
Olfa Jomaa Department of Rheumatology, Tahar Sfar University Hospital, Mahdia, Tunisia
Jihene Chelli Department of Rheumatology, Tahar Sfar University Hospital, Mahdia, Tunisia

DOI: https://doi.org/10.18502/ijhoscr.v18i4.16765

Keywords: Mantle cell lymphoma; Vertebrae; Infected tumor

Abstract

Primary vertebral lymphoma is an exceedingly rare entity. We hereby report a case of a 67-year-old male who presented to our department with fever, weight loss, and progressively worsening lower back pain radiating to the right hip. Physical examination showed pain on percussion of the dorsal and lumbar spine and tenderness on palpation of the right upper thigh area. The radiographic findings revealed numerous vertebral lesions with a right psoas abscess extending to the right upper thigh. Intravenous antibiotic therapy was initiated and the patient underwent an incision and drainage of the psoas abscess with a favourable outcome. However, given the suspicious imaging findings of the osseous lesions suggestive of malignancy, a vertebral biopsy was performed and yielded histo-pathological findings consistent with bone mantle cell lymphoma. To the best of our knowledge, this is the first case of an infected primary bone mantle cell lymphoma with multiple vertebral involvement. The diagnosis is challenging and can be confused with other diseases.