骨骼弥漫大B细胞淋巴瘤（DLBCL-bone）是一种异质性疾病。关于使用FDG正电子发射计算机体层摄影进行疗效评估的数据有限，尽管完全缓解后可能显示残留亲和性。我们分析了新诊断的DLBCL患者的临床数据，并鉴定出了所有DLBCL-bone病例。两位独立专家对治疗结束后的扫描进行了评估，将骨骼病变分为Deauville ≤ 3级、Deauville ≥ 4级或骨髓（M）病变、骨折（F）或手术（S）部位对应的反应性摄取。我们将DLBCL-bone的结果与其他局部淋巴结外位点（EN）进行了比较，根据IPI特征和治疗方案进行匹配。在1860例DLBCL患者中（骨骼占16％；EN占45％；淋巴结占39％），有41％患有局部病变，59％患有晚期病变。只有9％的患者（27例）在初次诊断时骨骼受累残留了FDG亲和性。在这些病例中，一半的摄取被归因于F/S/M，剩下的13例中，只有2例是真正的难治性病变（在其他部位有持续病变）。总生存率和无病进展生存率发现早期淋巴结DLBCL和DLBCL-bone的表现相似，但EN-DLBCL的表现较差。涉及骨骼的晚期疾病与淋巴结病变和EN-DLBCL的5年无病进展生存率相似。在进行IPI和治疗方案匹配后，骨骼和其他EN部位的无进展生存率相似。DLBCL的骨骼侵犯并不预示着较差的预后。5-10％的病例有望出现EOT Deauville ≥ 4级，但在没有其他难治性疾病迹象的情况下，可以采取观察策略。

Osseous involvement by diffuse large B-cell lymphoma (DLBCL-bone) is a heterogeneous disease. There is limited data regarding response assessment by positron emission tomography with FDG, which may demonstrate residual avidity despite a complete response. We analyzed clinical data of patients with newly diagnosed DLBCL and identified all cases with DLBCL-bone. End of treatment scans were reviewed by two independent experts classifying osseous lesions into Deauville ≤3; Deauville ≥ 4, or reactive uptake in the bone marrow (M), site of fracture (F) or surgery (S). We compared outcomes of DLBCL-bone to other extranodal sites (EN) matched on IPI features and regiment. Of 1860 patients with DLBCL (bone 16%; EN 45%; nodal 39%), 41% had localized disease and 59% advanced. Only 9% (27) of patients with initial bone involvement had residual FDG avidity at the osseous site. In half of these cases, the uptake was attributed to F/S/M, and of the remaining 13, only 2 were truly refractory (both with persistent disease at other sites). Overall survival and progression-free survival were found to be similar for early-stage nodal DLBCL and DLBCL-bone, but inferior in EN-DLBCL. Advanced stage disease involving the bone had a similar 5-year progression-free survival to nodal disease and EN-DLBCL. After matching for IPI and treatment regiments, PFS between bone and other EN sites was similar. Osseous involvement in DLBCL does not portend a worse prognosis. EOT Deauville ≥4 can be expected in 5-10% of cases, but in the absence of other signs of refractory disease, may be followed expectantly.