title: Multiple osteolytic lesions and testicular involvement at first relapse of follicular lymphoma grade 1 in transformation.
abstract: A 62-year-old man was initially diagnosed with stage IA follicular lymphoma grade 1 of the left tonsil. Shortly after radiotherapy he rapidly developed multiple painful acroosteolytic lesions and testicular involvement. The histological examination revealed a transformed lymphoma in the testis (DLCL) and follicular lymphoma in the acroosteolytic lesions. The clonal identity of lymphoma cells within the primary biopsy as well as in the two sites at relapse was shown by PCR and nucleotide sequence analysis of the lymphoma clone specific B-cell receptor rearrangement. Chemotherapy with six cycles of CHOP followed by high dose chemotherapy and autologous blood stem cell transplantation led to a complete clinical remission with disappearance of all osteolytic lesions.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany. doelken@uni-greifswald.de
authors.forename: Marc T
authors.initials: MT
authors.lastname: Dölken
authors.forename: Frank
authors.initials: F
authors.lastname: Schüler
authors.forename: Carsten
authors.initials: C
authors.lastname: Hirt
authors.forename: Gerd
authors.initials: G
authors.lastname: Lorenz
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
authors.forename: Gottfried
authors.initials: G
authors.lastname: Dölken
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010014:Osteolysis / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012074:Remission Induction; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014182:Transplantation, Autologous; D016896:Treatment Outcome