Bone Marrow Involvement in Non-Hematological Malignancy
A Clinico-pathological Study From a Tertiary Hospital
Keywords:
Bone marrow metastasis, non hematological malignancies, Bone marrow aspiration, Hematological Findings
Abstract
Background- Bone marrow is an important site for metastasis in cases of non hematological malignancies and is routinely performed to stage the disease or to rule out metastasis in suspected cases.. Purpose- Purpose of the study is to evaluate bone marrow in cases of solid tumors and also to enumerate the types of tumors metastasizing to marrow at our institute. Methods- This was a retrospective study and clinical and laboratory data were retrieved from case files and laboratory records. All the case where bone marrow aspirate was performed to rule out metastasis or for staging were included along with those cases where patient presented to us with hematological abnormalities and diagnosed to have a metastasis in marrow. Results- Out of total 758 cases of total bone marrow performed, 89 were performed in proven cases of non hematological malignancies of which 31 showed tumor deposits. While in two cases metastatic deposits were first seen in marrow aspirate. Most common tumor metastasizing to marrow at our institute was adenocarcinoma of lung followed by breast and small cell carcinoma of lung. In pediatric age group most common tumor was Ewing’s sarcoma followed by rhabdomyosarcoma. Most common peripheral smear abnormality seen was thrombocytopenia followed by anemia and leukoerythroblastic blood picture. Conclusion- Bone marrow aspiration is an easy, rapid and sensitive technique to determine metastasis of solid tumors in bone marrow and can be performed in hematological abnormalities to rule out any metastasis in otherwise unsuspected cases.References
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2) Sambit KM, Dash S. Bone marrow metastasis in solid tumors Indian Journal Pathology & Microbiology 2003; 46(4):613-16
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4) Bain BJ, Clark DM, Wilkins BS, Lampert IA. Metastatic tumors. In: Bain BJ, Clark DM, Wilkins BS, editors. Bone Marrow Pathology. 3rd ed. England, Malden, MA: Blackwell Science, Bon Oxford; 2001. p. 430-61
5) Valdes-Sanchez M, Nava-Ocampo AA, Palacios-Gonzalez RV, Perales-Arroyo A, Medina-Sanson A, Martinez-Avalos A. Diagnosis of bone marrow metastases in children with solid tumors and lymphomas. Aspiration, or unilateral or bilateral biopsy? Archives of Medical Research. 2000;Jan-Feb; 31(1) :58–61.
6) Takemoto C, Nishiuchi R, Endo C, Oda M, Seino Y. Comparison of two methods for evaluating bone marrow metastasis of neuroblastoma: reverse transcription-polymerase chain reaction for tyrosine hydroxylase and magnetic resonance imaging. Pediatrics Internasional. 2004; Aug, 46 (4) :387–93.
7) Kilickap S, Erman M, Dincer M, Aksoy S, Hakan H, Yalcin Y et. al. Bone marrow metastasis of solid tumors: clinicopathological evaluation of 73 cases. Turkish Journal of Cancer 37(3):85–88
8) Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases. BMC Cancer 2005;5:144
9) Mishr P. Das S, Kar R, Jacob SE, Basu D. Non-haemoatopoietic malignancies metastasing to the bone marrow: A 5 year record based descriptive study from a tertiary care centre in south India. INdian Journal of CANCER 2014: 51(1) ;30-34.
10) Atac B, Lawrence C, Goldberg SN. Metastatic tumors .The complementary role of marrow aspirate and biopsy. American Journal of the medical Sciences. 1991; Oct 302(4):211-13
11) Sar R, Aydogdu I, Ozen S et al .Metastatic bone marrow tumors: A report of six cases and review of literature. Hematologia 2001; 31(3):215-23
12) Singh G, Krause JR, Breitfeld V. Bone marrow involvement by metastatic tumors: for metastatic tumor: aspirate and biopsy. Cancer 1977 Nov, 40 (5):2317-21.
13) Chauhan K, Jain M, Grover S, Shukla P, Rusia U, Grover RK. Bone marrow metastisis in nonhematologic malignancies: Data from a cancer hospital. Clinical cancer Investigation journal 2016; 5 (2), 103-109.
14) MM Reid, JP Walls, A.G. Mc Guckin et al. Routine Histological compared with immunohistological examination of bone marrow trephine biopsy specimens in disseminated neuroblastoma. Journal of Clinical Pathology 1991: June 44(6); 483-86
15) Pangrahi R, Behera PK, Tripathy KP. Bone marrow involvement in Non hematological Disrorders-An Institutional Experience. IOSR Journal of Dental and Medical Sciences. 2017;April 16 (4); 51-53.
16) Clevenger, C. V., Khandewal, M., Stadtmauer, E., and Jardines, L. Detection of bone marrow breast carcinoma metastasis using multiparameter flow cytometry. Annals of the New York Academy of Sciences. 193 Mar 20; 677: 400–1.
17) Pelkey TJ, Frierson HF, Bruns DE. Molecular and immunological detection of circulating tumor cells and micrometastases from solid tumors. Clinical chemistry. 1996 Sep; 42(9):1369-81.
18) Raj, G. V., Moreno, J. G., and Gomella, L. G. Utilization of polymerase chain reaction technology in the detection of solid tumors. Cancer. 1998 Apr 15;82(8):1419–42.
19) Farah Moid, Louis De Palma Comparison of relative value of Bone marrow Aspirates and Bone marrow Trephine Biopsies in the Diagnosis of solid tumor metastasis and Hodgkin’s lymphoma; Institutional Experience and literature review, Archives of Pathology and Laboratory. Medicine. 2005 Apr,. 129 (4); 497-501.
2) Sambit KM, Dash S. Bone marrow metastasis in solid tumors Indian Journal Pathology & Microbiology 2003; 46(4):613-16
3) Kaur G, Basu S, Kaur P, Sood T. Metastatic bone marrow tumors: Study of nine cases and review of the literature. Journal of Blood Disorder and Transfusion 2011;2:110.
4) Bain BJ, Clark DM, Wilkins BS, Lampert IA. Metastatic tumors. In: Bain BJ, Clark DM, Wilkins BS, editors. Bone Marrow Pathology. 3rd ed. England, Malden, MA: Blackwell Science, Bon Oxford; 2001. p. 430-61
5) Valdes-Sanchez M, Nava-Ocampo AA, Palacios-Gonzalez RV, Perales-Arroyo A, Medina-Sanson A, Martinez-Avalos A. Diagnosis of bone marrow metastases in children with solid tumors and lymphomas. Aspiration, or unilateral or bilateral biopsy? Archives of Medical Research. 2000;Jan-Feb; 31(1) :58–61.
6) Takemoto C, Nishiuchi R, Endo C, Oda M, Seino Y. Comparison of two methods for evaluating bone marrow metastasis of neuroblastoma: reverse transcription-polymerase chain reaction for tyrosine hydroxylase and magnetic resonance imaging. Pediatrics Internasional. 2004; Aug, 46 (4) :387–93.
7) Kilickap S, Erman M, Dincer M, Aksoy S, Hakan H, Yalcin Y et. al. Bone marrow metastasis of solid tumors: clinicopathological evaluation of 73 cases. Turkish Journal of Cancer 37(3):85–88
8) Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases. BMC Cancer 2005;5:144
9) Mishr P. Das S, Kar R, Jacob SE, Basu D. Non-haemoatopoietic malignancies metastasing to the bone marrow: A 5 year record based descriptive study from a tertiary care centre in south India. INdian Journal of CANCER 2014: 51(1) ;30-34.
10) Atac B, Lawrence C, Goldberg SN. Metastatic tumors .The complementary role of marrow aspirate and biopsy. American Journal of the medical Sciences. 1991; Oct 302(4):211-13
11) Sar R, Aydogdu I, Ozen S et al .Metastatic bone marrow tumors: A report of six cases and review of literature. Hematologia 2001; 31(3):215-23
12) Singh G, Krause JR, Breitfeld V. Bone marrow involvement by metastatic tumors: for metastatic tumor: aspirate and biopsy. Cancer 1977 Nov, 40 (5):2317-21.
13) Chauhan K, Jain M, Grover S, Shukla P, Rusia U, Grover RK. Bone marrow metastisis in nonhematologic malignancies: Data from a cancer hospital. Clinical cancer Investigation journal 2016; 5 (2), 103-109.
14) MM Reid, JP Walls, A.G. Mc Guckin et al. Routine Histological compared with immunohistological examination of bone marrow trephine biopsy specimens in disseminated neuroblastoma. Journal of Clinical Pathology 1991: June 44(6); 483-86
15) Pangrahi R, Behera PK, Tripathy KP. Bone marrow involvement in Non hematological Disrorders-An Institutional Experience. IOSR Journal of Dental and Medical Sciences. 2017;April 16 (4); 51-53.
16) Clevenger, C. V., Khandewal, M., Stadtmauer, E., and Jardines, L. Detection of bone marrow breast carcinoma metastasis using multiparameter flow cytometry. Annals of the New York Academy of Sciences. 193 Mar 20; 677: 400–1.
17) Pelkey TJ, Frierson HF, Bruns DE. Molecular and immunological detection of circulating tumor cells and micrometastases from solid tumors. Clinical chemistry. 1996 Sep; 42(9):1369-81.
18) Raj, G. V., Moreno, J. G., and Gomella, L. G. Utilization of polymerase chain reaction technology in the detection of solid tumors. Cancer. 1998 Apr 15;82(8):1419–42.
19) Farah Moid, Louis De Palma Comparison of relative value of Bone marrow Aspirates and Bone marrow Trephine Biopsies in the Diagnosis of solid tumor metastasis and Hodgkin’s lymphoma; Institutional Experience and literature review, Archives of Pathology and Laboratory. Medicine. 2005 Apr,. 129 (4); 497-501.
Published
2018-05-29
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