MRI and Radiography of Primary Bone Lymphoma

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.00
Procedures: 1.00
Head, Spine, and Musculoskeletal: 1.00

Magnetic Resonance Imaging: 2.00
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.00
Neurological: 0.50
Musculoskeletal: 0.50

Nuclear Medicine Technology: 2.00
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.00
Other Imaging Procedures: 1.00

Radiography: 2.00
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.00
Head, Spine and Pelvis Procedures: 0.50
Extremity Procedures: 0.50

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Musculoskeletal and Endocrine Sections: 1.00
Neurological, Vascular, and Lymphatic Sections: 1.00

Radiation Therapy: 2.00
Patient Care: 1.00
Patient and Medical Record Management: 1.00
Procedures: 1.00
Treatment Sites and Tumors: 1.00

Outline

1. Introduction
2. Clinical & Histologic Features
3. Clinical Characteristics
4. Histropathologic Characteristics
5. Radiographic Charateristics
6. Lytic-Destructive Pattern
7. Subtle or “Near-Normal” findings
8. MR Imaging Characteristics
9. Soft Tissue Involvement
10. Coritcal Erosion
11. Differential Diagnosis
12. Treatment
13. Conclusions

Objectives

Upon completion of this course, students will:

1. understand the characteristics of primary bone lymphoma
2. be familiar with the alternate names for PBL.
3. know the frequency of occurrence of PBL
4. understand what age groups most patients diagnosed with PBL are in
5. be familiar with the most common affected site for PBL
6. understand those areas NOT commonly affected by PBL
7. know what radicular symptoms indicate regarding PBL
8. understand the signs of PBL
9. know what bone involvement of disseminated malignant lymphoma means
10. understand how nodal disease is involved in the diagnosis of PBL.
11. understand how disseminated disease is involved in the diagnosis of PBL.
12. know the lineage of cells that PBL is made up of
13. be familiar with the types of cells PBL could be made up of
14. know during which decade the criteria for diagnosis PBL were initially suggested
15. understand what period of time lymphoma in a bony site with no evidence of disease elsewhere suggests
16. be familiar with the factors that are necessary to rule out a diagnosis of PBL
17. understand how PBL appears on various imaging modalities
18. know the most common X-ray appearance of PBL
19. understand what small elongated rarefactions parallel to the long axis of the bone characterize
20. understand what medium and large patches of radiolucency characterize
21. understand the clinical implications of a lytic pattern
22. understand the clinical implications of a sudden interruption in the continuity of the cortex
23. know which imaging modalities best demonstrate an interruption of the cortex
24. be familiar with the imaging modalities that can demonstrate sequestra findings
25. be familiar with the frequency of occurrence of periosteal reaction
26. understand how the appearance of PBL on radiographs may differ striking from on MR
27. compare the sensitivity of MR and scintigraphy
28. know which MR pulse sequence demonstrates marrow changes best
29. be familiar with the appearance of PBL on various MR images
30. understand the appearance of reactive marrow on T2-weighted images
31. know the appearance of fibrosis
32. be familiar with the appearance of STIR images
33. understand the relationship between a permeative pattern and other symptoms of PBL
34. know on which imaging modalities cortical erosion can be demonstrated
35. be familiar with the possible differential diagnoses of PBL