Isolated Vertebral Body Osteopoikilosis Confusing As Lymphoma

Background: Osteopoikilosis is an asymptomatic and rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Concurrent isolated vertebral osteosclerotic lesion with non tender axillary lymphnodes may mimic lymphoma as well. We present a case of isolated vertebral osteopoikilosis that mimicked a lymphoma. Study Design/Setting: A 19 year old female student presented with acute back pain at the thoracic spine region. She had two non-tender, mobile axillary lymphnodes Plain X-ray showed isolated vertebral osteosclerotic lesions mainly at thoracic level. Methods:  The patient underwent radiological imaging followed by transpedicular trucut biopsy from D12 vertebra and FNAC of axillary lymphnodes for establishing the diagnosis. Histopathological examination of vertebral biopsy showed normal bone architecture with no evidence of new bone formation or malignancy. Axillary lymphnode biopsy showed only hyperplasia. Hence we diagnosed the patient’s vertebral lesions as osteopoikilosis. Results:  The cause of her pain might have been due to paraspinal strain which responded well to analgesics and rest. Conclusions: Concurrent isolated vertebral osteosclerotic lesion with non tender axillary lymphnodes can mimic lymphoma or even other skeletal malignancies. Tissue biopsy is highly recommended to avoid misdiagnosis especially in confusing cases like ours. In our literature review we did not find any previously reported cases of isolated vertebral osteopoikilosis that mimicked lymphoma. end{abstract}