{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:49:30Z","timestamp":1780109370113,"version":"3.54.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Skeletal Radiol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Paget\u2019s disease of bone (PDB) is a skeletal remodeling disorder diagnosed primarily via radiographs. In long bones, the early lytic stage of the disease is characterized by flame-shaped or blade of grass radiolucent bone resorption beginning in subchondral bone with variable length of extension into the metadiaphysis, and the later stages show bone expansion, cortical thickening, and coarsening of the trabeculae [1, 2]. Despite the usually diagnostic features, other considerations with overlapping appearance include aggressive benign and malignant bone tumors [3]. Malignancy such as lymphoma can present shared clinical features to PDB. When there is doubt as to the diagnosis, biopsy should be performed. A 60-year-old male presented with chronic left lower extremity pain. Radiographs showed a flame-shaped lytic lesion in the left femur with corresponding uptake on the bone scintigraphy. Radiographic features were suggestive of PDB, but due to some atypical findings, a biopsy was performed and showed small lymphocytic lymphoma (SLL) in the setting of chronic lymphocytic leukemia (CLL). This diagnosis led to the patient being promptly treated with targeted therapy and radiation. Pathologic verification is critical in an aberrant presentation of PDB to mitigate misdiagnosis and establish an appropriate therapeutic course.<\/jats:p>","DOI":"10.1007\/s00256-025-05003-3","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T02:55:22Z","timestamp":1756868122000},"page":"471-475","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lymphoma masquerading as Paget\u2019s disease of bone: a rare diagnostic challenge"],"prefix":"10.1007","volume":"55","author":[{"given":"Irina D.","family":"Sokolik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy A.","family":"Damron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"issue":"6 Suppl","key":"5003_CR1","doi-asserted-by":"publisher","first-page":"S64","DOI":"10.2214\/AJR.10.7222","volume":"196","author":"DJ Theodorou","year":"2011","unstructured":"Theodorou DJ, Theodorou SJ, Kakitsubata Y. Imaging of Paget disease of bone and its musculoskeletal complications: review. AJR Am J Roentgenol. 2011;196(6 Suppl):S64\u2013S75.\nhttps:\/\/doi.org\/10.2214\/AJR.10.7222\n.","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"5003_CR2","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/BF00228919","volume":"24","author":"JM Mirra","year":"1995","unstructured":"Mirra JM, Brien EW, Tehranzadeh J. Paget\u2019s disease of bone: review with emphasis on radiologic features. Part II Skeletal Radiol. 1995;24(3):173\u2013184.\nhttps:\/\/doi.org\/10.1007\/BF00228919.","journal-title":"Part II Skeletal Radiol"},{"issue":"3","key":"5003_CR3","first-page":"100","volume":"41","author":"C Britton","year":"2012","unstructured":"Britton C, Walsh J. Paget disease of bone - an update. Aust Fam Physician. 2012;41(3):100\u2013103.","journal-title":"Aust Fam Physician"},{"issue":"11","key":"5003_CR4","first-page":"4905","volume":"32","author":"J Mika","year":"2012","unstructured":"Mika J, Schleicher I, Gerlach U, et al. Primary bone lymphomas thought to be osteomyelitis urgently demand a rapid diagnosis in bone pathology. Anticancer Res. 2012;32(11):4905\u20134912.","journal-title":"Anticancer Res"},{"issue":"13","key":"5003_CR5","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.1182\/blood-2005-04-1753","volume":"106","author":"K Fu","year":"2005","unstructured":"Fu K, Weisenburger DD, Greiner TC, et al. Cyclin D1-negative mantle cell lymphoma: a clinicopathologic study based on gene expression profiling. Blood. 2005;106(13):4315\u20134321.\nhttps:\/\/doi.org\/10.1182\/blood-2005-04-1753\n.","journal-title":"Blood"},{"key":"5003_CR6","doi-asserted-by":"publisher","unstructured":"Wierda WG, Brown J, Abramson JS, et al. Chronic lymphocytic leukemia\/small lymphocytic lymphoma, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2024;22(3):175\u2013204.https:\/\/doi.org\/10.6004\/jnccn.2024.0018","DOI":"10.6004\/jnccn.2024.0018"},{"key":"5003_CR7","doi-asserted-by":"publisher","unstructured":"Bennett-Caso C, Kravtsov O, Damron TA. A case report of progressive Paget disease mimicking a malignancy: a second episode 21 years later. JBJS Case Connect. 2023;13(3):https:\/\/doi.org\/10.2106\/JBJS.CC.22.00694.Published 2023 Jul 31.https:\/\/doi.org\/10.2106\/JBJS.CC.22.00694","DOI":"10.2106\/JBJS.CC.22.00694"},{"key":"5003_CR8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s002560000313","volume":"30","author":"J McNairn","year":"2001","unstructured":"McNairn J, Damron T, Landas S, et al. Benign tumefactive soft tissue extension from Paget\u2019s disease of bone simulating malignancy. Skeletal Radiol. 2001;30:157\u2013160.\nhttps:\/\/doi.org\/10.1007\/s002560000313.","journal-title":"Skeletal Radiol"},{"issue":"11","key":"5003_CR9","doi-asserted-by":"publisher","first-page":"2992","DOI":"10.1007\/s11999-010-1401-x","volume":"468","author":"S Kasraeian","year":"2010","unstructured":"Kasraeian S, Allison DC, Ahlmann ER, Fedenko AN, Menendez LR. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res. 2010;468(11):2992\u20133002.\nhttps:\/\/doi.org\/10.1007\/s11999-010-1401-x\n.","journal-title":"Clin Orthop Relat Res"}],"container-title":["Skeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-025-05003-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00256-025-05003-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-025-05003-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:16:26Z","timestamp":1766726186000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00256-025-05003-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["5003"],"URL":"https:\/\/doi.org\/10.1007\/s00256-025-05003-3","relation":{},"ISSN":["0364-2348","1432-2161"],"issn-type":[{"value":"0364-2348","type":"print"},{"value":"1432-2161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]},"assertion":[{"value":"21 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was not required as case report contains deidentified patient information. Informed consent was provided by the patient for this case study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}