Between 1972 and 1985, 127 patients with non-Hodgkin lymphoma of bone and soft tissue were evaluated and registered by National Cancer Center. In Japan, lymphomas of upper extremities are very uncommon. We reported a rare case of malignant lymphoma of the left 5th metacarpal bone. A 78-year-old male was admitted complaining of severe swelling over the left hand. The preoperative examination demonstrated only the diffuse, swelled, painful dorsal site of the left 5th metacarpal bone. No lymph nodes were palpated. Routine laboratory data were within normal values except ESR and IgA. The plain roentgenogram revealed osteolytic change in the whole 5th metacarpal bone. High uptake was observed on the lesion by 99mTc. scintigram. At operation, soft tissues were edematous and the lesion was found to have a lytic change. Frozen section suspected malignancy, and we immediately proceeded a wide resection. The curetted material showed diffuse pattern consisting of small, rounded lymphocytes and it was diagnosed as malignant lymphoma. Postoperatively chemotherapy was started to prevent local reccurence and distant metastasis. Lymphangiograpy of retroperitoneum, Ga. scintigram, and 99mTc. scintigram showed no abnormal changes.
