(P 520) ORTHOPEDIC MANIFESTATIONS OF LYMPHOPROLIFERATIVE NEOPLASMS

Objective: Lymphoproliferative disorders are rare inflammatory conditions with the ability to cause musculoskeletal pathology. Rosai-Dorfman, Kimura, and Castleman’s disease, seldom present with an orthopedic chief complaint. As a result, there is a paucity of data describing the musculoskeletal manifestations of these lymphoproliferative disorders. This often leads to a delay in diagnosis and treatment. This study serves to better characterize the musculoskeletal manifestations of lymphoproliferative disorders and review management recommendations.

Methods: This is a single-surgeon cohort of 3 patients with unusual lymphoproliferative diagnoses seen at a single tertiary care hospital between March 2022 and March 2023.

Results: Mean age and BMI were 35 years (range 23-51) and 23.7 kg/m2 at the time of diagnosis. All patients were male. On average, 3 biopsies were necessary to reach an accurate diagnosis. One patient required 5 biopsies and was treated with multiple operations and radiation prior to reaching an accurate diagnosis. Alternative diagnoses included sarcoma, lymphoma, granuloma, osteomyelitis, arteriovenous malformation, and nodular fasciitis. All 3 patients required surgery by the senior author for definitive diagnosis and treatment (Table 1 and Figure 1).

Conclusion: When rare lymphoproliferative disorders occur in the musculoskeletal system, they are difficult to diagnose. History, physical examination, and advanced imaging can be helpful; however, appropriate interpretation of the biopsy by an experienced pathologist is key. This case series highlights 3 of these disorders, common presenting features, differential diagnoses, imaging findings, and treatment.