Bone tumours: primary lymphoma of bone: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone tumours: primary lymphoma of bone

Sample item

A 55-year-old man has a month of thigh pain. Radiographs show a permeative, moth-eaten lesion of the femoral diaphysis with a soft tissue mass. He looks well. Biopsy shows large B cells. What is the main treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Chemotherapy, with radiotherapy as an adjunct

Primary lymphoma of bone is most often diffuse large B-cell lymphoma and, unlike osteosarcoma, responds well to combination chemotherapy with or without radiotherapy. Surgery is mainly for fixation of impending fractures. The patient often appears well in spite of an extensive radiographic lesion.

Option by option

  • A. Chemotherapy, with radiotherapy as an adjunct (correct)

    Correct. Chemotherapy with radiotherapy is the treatment of bone lymphoma.

  • B. Wide resection with endoprosthesis

    Resection is not the primary treatment for a chemosensitive lymphoma.

  • C. Curettage and cementing

    Curettage is for benign lesions.

  • D. Observation

    Untreated lymphoma progresses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Chemotherapy, with radiotherapy as an adjunct. Primary lymphoma of bone is most often diffuse large B-cell lymphoma and, unlike osteosarcoma, responds well to combination chemotherapy with or without radiotherapy.

Why is "Wide resection with endoprosthesis" not the answer?

Resection is not the primary treatment for a chemosensitive lymphoma.

Why is "Curettage and cementing" not the answer?

Curettage is for benign lesions.

Why is "Observation" not the answer?

Untreated lymphoma progresses.

What concept does this question test?

It tests Bone tumours: primary lymphoma of bone in Orthopaedics. Surgery is mainly for fixation of impending fractures. The patient often appears well in spite of an extensive radiographic lesion.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone tumours: primary lymphoma of bone?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.