[Cytology of bone marrow metastases of malignant tumors]. / Die Zytologie der Knochenmarkmetastasen von bösartigen Tumoren.

It is reported on the bone marrow involvement of 389 malignant tumors investigated by sternal marrow aspiration. The frequency of skeletal metastases as revealed by routinely taken bone marrow aspiration was 20.3%. Bone marrow metastases were detected mostly in tumors of prostatic, pancreatic, renal and ovarian origin, in cancers of the breast and in melanoblastoma. Positive cytological findings increased to 29.0% in those metastatic tumors, where the frequency of metastases had been identified with clinical and different laboratory methods. In cases, where these methods detected the primary tumor only, the metastatic frequency was 13.4% in form of micrometastases, invisible by x-ray examination. The cell type of the metastatic tumor did not allow to localize the primary site of the disease. Non-specific reactions as eosinophilia and microgranuloma, both increased, are not specific but suspicious of skeletal metastases.

Data on the clinical aspects and therapy of primary gastrointestinal lymphomas.

Fifteen cases of primary gastrointestinal lymphoma diagnosed over 8 years are reviewed. In the period 1980 to 1982 there was a cumulative appearance of GI lymphomas, nine out of 15 cases were diagnosed in that period. According to its localization, lymphoma occurred in 12 cases in the stomach, and in 3 in the small intestines and the colon. One case of gastric lymphoma was Hodgkin type, the others were non-Hodgkin types. The clinical symptoms were not characteristic of lymphoma. The age of the patients was, on the average, ten years lower than the mean age of carcinoma patients. Preoperative diagnosis by gastric biopsy was successful in four cases. In patients with lymphoma of the colon not subjects to surgery, colonoscopy verified the origin of lymphoma. Exact clinical classification in the majority of cases was made intraoperatively. In the non-operated cases, sonography and lymphography were performed. In general, operation was attempted, but patients in stage II, in very poor condition, were possibly not operated. The possibility and indications of the "second look" operation are discussed. Histological typing was made according to the Kiel classification. In the literature, in the most controversial question of therapy, individual consideration of the cases is recommended. Based on our experience, in devising therapy or therapeutic strategy as well as concerning prognosis, the degree of malignancy according to histological type, clinical stage and anatomical localization seem to be the most decisive factors. In exceptionally malignant cases a protocol with doxorubicine + bleomycin + teniposide and prednisolone was applied.