Diagnostic challenges are common in clinical practice and diagnostic or classification criteria for musculoskeletal conditions cannot overshadow clinical skills.
We present the case of a young man who complained of prolonged articular pain and mild swelling of the right ankle in the absence of other remarkable data. Apparently fulfilling the Budapest diagnostic criteria for complex regional pain syndrome, the patient was treated accordingly, but the pain increased over time. Then the patient underwent an additional diagnostic workup including synovial and bone biopsies in 2 separate occasions with the second one demonstrating diffuse lymphoid infiltrate compatible with lymphoma.
The conclusive diagnosis of primary diffuse large B-cell lymphoma of the talus was made and adequate treatment initiated.
The diagnostic difficulties as well as the importance of a multidisciplinary approach for complex cases are highlighted in this report.
Tumori 2017; 103(Suppl. 1): e62 - e65
Article Type: CASE REPORT
AuthorsOmbretta Annibali, Gianluigi Fabbriciani, Mariantonietta Tafuri, Marco Massarotti, Pietro Sedati, Valeria Tomarchio, Elena Sabattini, Stefano Pileri, Carlo Selmi, Giuseppe Avvisati
- • Accepted on 16/05/2017
- • Available online on 28/08/2017
- • Published online on 15/11/2017
This article is available as full text PDF.
- Annibali, Ombretta [PubMed] [Google Scholar] 1, Corresponding Author (firstname.lastname@example.org)
- Fabbriciani, Gianluigi [PubMed] [Google Scholar] 2, 3
- Tafuri, Mariantonietta [PubMed] [Google Scholar] 1
- Massarotti, Marco [PubMed] [Google Scholar] 3, 4
- Sedati, Pietro [PubMed] [Google Scholar] 5
- Tomarchio, Valeria [PubMed] [Google Scholar] 1
- Sabattini, Elena [PubMed] [Google Scholar] 6
- Pileri, Stefano [PubMed] [Google Scholar] 7
- Selmi, Carlo [PubMed] [Google Scholar] 3, 8
- Avvisati, Giuseppe [PubMed] [Google Scholar] 1
Hematology and Stem Cell Transplantation Unit, University Campus Bio-Medico, Rome - Italy
Reumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan - Italy
Rheumatology and Clinical Immunology Unit, Humanitas Clinical and Research Center, Milan - Italy
Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster - UK
Radiology Unit, University Campus Bio-Medico, Rome - Italy
Hematopathology Section, Department of Hematology and Oncological Sciences “L. and A. Seràgnoli,” S. Orsola-Malpighi Hospital, University of Bologna, Bologna - Italy
Haematopathology Unit, European Institute of Oncology, Milan - Italy
BIOMETRA Department, University of Milan, Milan - Italy
Ombretta Annibali and Gianluigi Fabbriciani contributed equally to this work.