{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:12Z","timestamp":1756361412121,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,21]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>We present a case of primary diffuse large B-cell lymphoma of bone accompanied by osteomyelitis, which was challenging to diagnose. CT revealed no distant metastases; thus, primary bone tumour and osteomyelitis were included in the differential diagnosis. A needle biopsy of an extraosseous lesion found no malignancy, and granulation tissue with abscess formation was pathologically diagnosed. An incisional biopsy was performed to assess osteomyelitis. A culture grew <jats:italic>Listeria monocytogenes,<\/jats:italic> but malignant lymphoma was diagnosed based on a pathological analysis of an open biopsy specimen. Imaging studies demonstrated diffuse, intrafemoral spread of the tumour. However, the extent of the spread of the lymphoma and osteomyelitis was unclear. Hip disarticulation was performed to eradicate the infection, and chemotherapy was administered. Primary lymphoma of bone is difficult to differentiate from an infection on imaging studies, and its co-occurrence with osteomyelitis at the initial presentation, as in this case, is extremely rare.<\/jats:p>","DOI":"10.1136\/bcr-2024-264770","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T04:30:23Z","timestamp":1749702623000},"page":"e264770","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary lymphoma of bone in the femur complicated by a fracture and listeria osteomyelitis"],"prefix":"10.1136","volume":"18","author":[{"given":"Sachi","family":"Koyama","sequence":"first","affiliation":[{"name":"Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Japan"},{"name":"Orthopaedics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masachika","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Motoi","sequence":"additional","affiliation":[{"name":"Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihide","family":"Hirai","sequence":"additional","affiliation":[{"name":"Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"2025082722364941000_18.6.e264770.1","doi-asserted-by":"crossref","DOI":"10.3390\/diseases11010042","article-title":"Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis","volume":"11","author":"Kanavos","year":"2023","journal-title":"Diseases"},{"key":"2025082722364941000_18.6.e264770.2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4236\/ojcd.2015.53017","article-title":"Primary Lymphoma of Bone: Imaging Findings to Improve Diagnosis of a Rarely Considered Disease Prior to Biopsy","volume":"05","author":"Caracciolo","year":"2015","journal-title":"OJCD"},{"key":"2025082722364941000_18.6.e264770.3","first-page":"4905","article-title":"Primary bone lymphomas thought to be osteomyelitis urgently demand a rapid diagnosis in bone pathology","volume":"32","author":"Mika","year":"2012","journal-title":"Anticancer Res"},{"key":"2025082722364941000_18.6.e264770.4","unstructured":"WHO . Classification of tumours. soft tissue and bone tumours. 5th edn. Lyon: International Agency for Research on Cancer, 2020."},{"key":"2025082722364941000_18.6.e264770.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-007-0335-1"},{"key":"2025082722364941000_18.6.e264770.6","doi-asserted-by":"crossref","first-page":"036","DOI":"10.1055\/s-0038-1676125","article-title":"Ewing\u2019s Sarcoma and Primary Osseous Lymphoma: Spectrum of Imaging Appearances","volume":"23","author":"Weber","year":"2019","journal-title":"Semin Musculoskelet Radiol"},{"key":"2025082722364941000_18.6.e264770.7","doi-asserted-by":"crossref","first-page":"114","DOI":"10.5152\/eurasianjmed.2023.0060","article-title":"Should Core Needle Lymph Node Biopsy be a Relevant Alternative to Surgical Excisional Biopsy in Diagnostic Work Up of Lymphomas?","volume":"55","author":"Mutlu","year":"2023","journal-title":"Eurasian J Med"},{"key":"2025082722364941000_18.6.e264770.8","unstructured":"National Comprehensive Cancer Network Guidelines Version 2 . B-cell lymphomas. 2025. Available: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/b-cell.pdf"},{"key":"2025082722364941000_18.6.e264770.9","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jiph.2023.03.013","article-title":"Mortality risk factors related to listeriosis - A meta-analysis","volume":"16","author":"Huang","year":"2023","journal-title":"J Infect Public Health"},{"key":"2025082722364941000_18.6.e264770.10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir803"},{"key":"2025082722364941000_18.6.e264770.11","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms12010178","article-title":"Clinical Findings of Listeria monocytogenes Infections with a Special Focus on Bone Localizations","volume":"12","author":"Bongiovanni","year":"2024","journal-title":"Microorganisms"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:36:58Z","timestamp":1756359418000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":11,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,12]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/bcr-2024-264770"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264770","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}