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Anaplastic large cell lymphoma (ALCL) is a neoplasia of T-cell or null-cell origin accounting for approximately 3% of non-Hodgkin lymphomas in adults and 10-30% of lymphomas in children. It involves the lymph nodes as well as various extranodal sites, but the involvement of bone as either the primary or secondary site of spread, is rare.A 47-year-old male presented with an ALCL and multiple bone lesions involving the vertebrae, ribs, and iliac bone, with no other site of involvement. Histologic findings included interstitial and focal bone infiltrate consisting of large pleomorphic cells with an inflammatory background and marked fibrosis. There was immunohistochemical expression of CD30, EMA, CD45RO, CD43, CD8, Glut-1 and ALK-1.There are 20 reported cases of ALCL (T/null cell) arising from the bone. To diagnose primary bone lymphoma it is necessary to first exclude systemic lymphoma of the lymph nodes or the skin with bone spread. The differential diagnoses include osteomyelitis, small round cell tumors, mainly Ewing sarcoma/PNET, metastatic carcinoma, melanoma, Hodgkin lymphoma and Langerhans' cell histiocytosis. In this case, the differential FDG accumulation in the lesions observed in the PET-CT was associated with the degree of Glut-1 expression.

Paragangliomas are neoplasms of the chromaffin tissue characterized by the synthesis and/or secretion of catecholamines. Their treatment depends on the extension and functional characteristics of the tumor. In this pathology, the anatomic and functional diagnostic evaluations provided by nuclear medicine imaging studies have significant usefulness.A 34-year-old male was diagnosed with a paraganglioma at the level of the aortic bifurcation by means of laboratory tests, imaging studies and nuclear medicine studies. Nuclear medicine was carried out with a scintigraphy with a norepinephrine analog, radioactive meta-iodo-benzyl-guanidine (131I-MIBG), which demonstrates functionally and specifically the presence of neoplastic adrenergic tissue and extratumoral extension. In addition, a positron emission tomography coupled with computed tomography with a radioactive analog of glucose locates the extratumoral activity at bone level. Nuclear medicine studies allow the diagnosis of a malignant paraganglioma with presence of bone metastasis. The therapy includes surgical removal of the tumor and ablation of residual malignant tissue and metastatic lesions by radiotherapy with 131I-MIBG. Radiotherapeutic treatment was possible due to the capacity of the tumor to uptake and to concentrate the radioactive hormonal analog.In cases of paraganglioma, in addition to the localization of the tumor and the evaluation of biochemical alterations, it is indispensable to obtain anatomic and functional evaluation provided by nuclear medicine studies in order to achieve appropriate diagnoses and treatment.