Morphological analysis of bone marrow metastases from neuroblastoma and rhabdomyosarcoma in children / 中华检验医学杂志

Objective:To retrospectively analyze the bone marrow smears of neuroblastoma and rhabdomyosarcoma in children and summarize the morphological characteristics of the two types of tumors invading the bone marrow to provide reference for the identification and differential diagnosis.Method:A total of 908 bone marrow specimens were collected from the outpatient and inpatient children who were diagnosed as Neuroblastoma and Rhabdomyosarcoma by pathological tissue or lymph node biopsy in Sun Yat-sen University Cancer Center from January 2013 to July 2020. Of which, 231 cases of tumor bone marrow metastasis were detected. Bone marrow smears were observed and analyzed, classified and summarized according to the morphological characteristics of tumor cells.Result:A total of 231 cases of bone marrow metastases were detected, including two types of tumors, 217 cases Neuroblastoma, with an invasion rate of 34.23%; 14 cases Rhabdomyosarcoma, with an invasion rate of 5.11%. The tumor cells of neuroblastoma were arranged in a pseudo-chrysanthemum or wall-like arrangement and most of them were surrounded by nerve fibers. According to cell size, they could be divided into large cell type and small cell type. Rhabdomyosarcoma cells were mainly medium in size, with vacuoles in the nucleus, and double, triple and multinucleated cells can be seen. The cytoplasm was gauze-like, with bead-like vacuoles at the edges. According to the morphological characteristics of neuroblastoma and rhabdomyosarcoma, they can be differentiated from acute leukemia.Conclusion:Among two malignant solid tumors in children, Neuroblastoma had a higher bone marrow invasion rate, while Rhabdomyosarcoma had a lower bone marrow invasion rate. Rhabdomyosarcoma can be initially divided into embryonal type and acinar type according to whether tumor cells were fused or not.

Research advance in bone marrow metastasis in children′s neuroblastoma / 国际儿科学杂志

Neuroblastoma is the most common extracranial solid tumor for infants and young children.About 50% of patients have extensive metastasis before diagnosis, and the neuroblastoma can metastasize to bone marrow, bone, lymph node, orbit, liver and skin.Bone marrow is the most common site of neuroblastoma metastasis and recurrence.Once neuroblastoma metastasize or relapse, their survival rate will reduce significantly.The mechanism of neuroblastoma bone marrow metastasis has not been elucidated.The drug resistance of tumor cells, the interaction of bone marrow microenvironment, and the regulation of cell signaling pathways may play important roles in regulating tumor cell bone marrow metastasis.This review summarizes the research progress of bone marrow metastasis in neuroblastoma, which helps us to better understand the mechanism of interaction between neuroblastoma and the bone marrow microenvironment, and to provide new ideas for the diagnosis and treatment of patients.

Case report of splenic and bone marrow metastasis from breast cancer and literature review / 国际外科学杂志

Objective@#To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.@*Methods@#Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23, 2019 were analyzed and literatures were reviewed.@*Results@#Patient admitted to hospital with pain in the left upper abdomen, accompanied with anemia and thrombocytopenia. CT suggested spleen occupying lesions. ECT implied bone metastasis. Bone marrow biopsy indicated breast cancer metastasis. Breast biopsy showed breast cancer. After using letrozole, the lesion of left breast and thevolume of spleen was reduced. The range of the spleen was lower than before. This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.@*Conclusions@#Splenic and bone marrow metastasis from breast cancer are rare. Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases. Detailed case data, targeted examinations, and comprehensive analysis are important for reducing misdiagnosis.

Case report of splenic and bone marrow metastasis from breast cancer and literature review / 国际外科学杂志

Objective To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.Methods Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23,2019 were analyzed and literatures were reviewed.Results Patient admitted to hospital with pain in the left upper abdomen,accompanied with anemia and thrombocytopenia.CT suggested spleen occupying lesions.ECT implied bone metastasis.Bone marrow biopsy indicated breast cancer metastasis.Breast biopsy showed breast cancer.After using letrozole,the lesion of left breast and thevolume of spleen was reduced.The range of the spleen was lower than before.This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.Conclusions Splenic and bone marrow metastasis from breast cancer are rare.Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases.Detailed case data,targeted examinations,and comprehensive analysis are important for reducing misdiagnosis.

Gastric Carcinoma Presentating as Marrow Metastasis – A Case Report

Gastric carcinoma primarily manifesting as bone marrow metastasis is very rare. Herewith we present a case of 50 year old male who initially presented with fever and easy fatigability. Haematological workup revealed leukoerythroblastic picture with thrombocytopenia. Bone marrow examination disclosed metastatic deposits of poorly differentiated gastric carcinoma. This case throws light on the rarity of gastric carcinoma presenting only as bone marrow metastasis in the absence of systemic spread or any specific complaints pertaining to gastric carcinoma.

Gastric Carcinoma with Bone Marrow Metastasis: A Case Series

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.

Microangiopathic Hemolytic Anemia as the First Manifestation of Metastatic Signet Ring Cell Carcinoma of Unknown Origin: A Case Report and Review of Literature / 대한진단검사의학회지

Microangiopathic hemolytic anemia (MAHA) occurs occasionally as a paraneoplastic syndrome in some solid tumors, but MAHA accompanied by signet ring cell carcinoma of an unknown origin is very rare. In this study, we present the case of an 80-yr-old man who was admitted to the hospital because of a 1-month history of lower back pain and dyspnea. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anemia with schistocytes, decreased haptoglobin levels, and a negative direct Coombs' test. Bone marrow examination, which was performed because of the progression of anemia, revealed bone marrow metastases of signet ring cell carcinoma with extensive bone marrow necrosis. However, the primary origin of this signet ring cell carcinoma was not found. When the cause of progressive MAHA is unknown, the possibility of cancer-associated MAHA must be excluded by performing additional tumor workup, including the detection of tumor markers, gastric and colorectal endoscopic examinations, bone marrow examinations, and positron emission tomography-computed tomography or bone scans.

Microangiopathic Hemolytic Anemia as the First Manifestation of Metastatic Signet Ring Cell Carcinoma of Unknown Origin: A Case Report and Review of Literature / 대한진단검사의학회지

Microangiopathic hemolytic anemia (MAHA) occurs occasionally as a paraneoplastic syndrome in some solid tumors, but MAHA accompanied by signet ring cell carcinoma of an unknown origin is very rare. In this study, we present the case of an 80-yr-old man who was admitted to the hospital because of a 1-month history of lower back pain and dyspnea. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anemia with schistocytes, decreased haptoglobin levels, and a negative direct Coombs' test. Bone marrow examination, which was performed because of the progression of anemia, revealed bone marrow metastases of signet ring cell carcinoma with extensive bone marrow necrosis. However, the primary origin of this signet ring cell carcinoma was not found. When the cause of progressive MAHA is unknown, the possibility of cancer-associated MAHA must be excluded by performing additional tumor workup, including the detection of tumor markers, gastric and colorectal endoscopic examinations, bone marrow examinations, and positron emission tomography-computed tomography or bone scans.

Peripheral Blood Eosinophilia: An Unusual Presentation of Bone Marrow Involvement in a Patient with Relapsed Thyroid Papillary Carcinoma / 대한혈액학회지

Peripheral blood eosinophilia is a well-known paraneoplastic manifestation, but its underlying mechanism is still unclear. Bone marrow metastasis may be a cause of malignancy-associated eosinophilia. However, there is limited evidence of the relationship between bone marrow metastasis and eosinophilia. Herein, we present a unique case of peripheral blood eosinophilia associated with bone marrow invasion in a patient having a history of papillary thyroid carcinoma. A 68-year old woman showed peripheral blood eosinophilia (91,525/mm3). Since the time she was initially diagnosed as having papillary thyroid carcinoma, eosinophilia had never been found and the other causes of eosinophilia were excluded. A bone marrow study revealed cancer cell infiltration; multiple lymphadenopathies and liver metastasis were also detected. We treated her with steroid; however, her eosinophilia did not respond to steroid and the patient died due to disease progression. Although peripheral blood eosinophilia and bone marrow metastasis are rare findings in patients with papillary thyroid carcinoma, we suggest that eosinophilia might be a sign of the bone marrow metastasis of papillary thyroid carcinoma.

The Usefulness of Measurement of Whole Body Count in Assessing Bone Marrow Metastasis in Cancer Patients with Increased Periarticular Bone Uptake on Follow-up Bone Scan: A Comparison with Bone Marrow Scan / 대한핵의학회잡지

PURPOSE: Increased periarticular uptake could be associated with peripheral bone marrow expansion in cancer patients with axial bone marrow metastasis. We compared bone scan and bone marrow scan to investigate whether the increased whole body count in patients with increased periarticular uptake on bone scan is useful in the diagnosis of axial marrow metastasis, and evaluate the role of additional bone marrow scan in these cases. MATERIALS AND METHODS: Twelve patients with malignant diseases who showed increased periarticular uptake on bone scan were included. Whole body count was measured on bone scan and it is considered to be increased when the count is more than twice of other patients. Bone marrow scan was taken within 3-7 days. RESULTS: Five hematologic malignancy, 3 stomach cancer, 2 breast cancer, 1 prostate cancer and 1 lung cacner were included. All three patients with increased whole body count on bone scan showed axial marrow suppression and peripheral marrow expansion. Eight of 9 patients without increased whole body count showed axial marrow suppression and peripheral marrow expansion. One turned out to be blastic crisis of chronic myelogeneous leukemia, and seven showed normal axial marrow with peripheral marrow expansion in chronic anemia of malignancy. The last one without increased whole body count showed normal bone marrow scan finding. CONCLUSION: Increased whole body count on bone scan could be a clue to axial bone marrow metastasis in cancer patients with increased periarticular uptake, and bone marrow scan is a valuable method for differential diagnosis in these cases.

Detection of adhesion molecules in bone marrow metastatic tumors of digestive system / 中国实用内科杂志

Objective To evaluate the role of 4 types of adhesion molecules in digestive system tumors with bone marrow metastasis.Methods The fresh bone marrow slies of 72 cases of digestive system tumor with bone marrow metastasis,including 26 gastric cancer,25 liver cancer,21 colorectal cancer,were obtained.The tumor cell slides of 76 cases of digestive system tumor without metastasis,including 32 gastric cancer,20 liver cancer,24 colorectal cancer,were obtained.The expressions of 4 kinds of adhesion molecules in two groups were studied by ABC immunohistochemical methods,and positive rate was recorded and accumulated points.Results ICAM-1、E-cad and CEA positive rates/CD44V6 accumulated points were up-regulated in gastric cancer cells in bone marrow;ICAM-1、CD44V6 accumulated points/CEA positive rate were up-regulated in liver cancer cells in bone marrow,while expression of E-cad had no difference;ICAM-1、CD44V6 and CEA accumulated points/E-cad positive rate were up-regulated in large bowel cancer cells in bone marrow.Conclusion Different adhesion molecules play coordinative or resistant role in digestive system tumor with bone marrow metastasis.