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We retrospectively reviewed the cases of eight patients with histiocytic lymphoma (reticulum-cell sarcoma) appearing as a primary bone lesion. Histological findings were classified according to the criteria of Rappaport. Lesions were staged as suggested by the Ann Arbor Conference. After thorough staging, four of the eight patients were shown to have more extensive disease than was initially thought, which altered the therapeutic approach used. Thorough staging is necessary for improved survival of patients with histiocytic lymphoma of bone. We suggest a diagnostic strategy for patients with histiocytic lymphoma presenting in bone that leads to appropriate therapy.