scholarly journals Bone marrow metastasis of prostatic adenocarcinoma with post-treatment foamy-like changes: A diagnostic pitfall

2014 ◽  
Vol 8 (11-12) ◽  
pp. 941
Author(s):  
Nuri Yigit ◽  
Julia Turbiner Geyer
Keyword(s):  
Bone Marrow ◽  
Hormonal Therapy ◽  
Bone Marrow Involvement ◽  
Malignant Tumour ◽  
Treatment Modalities ◽  
Neoplastic Cells ◽  
Diagnostic Pitfall ◽  
Stage Disease ◽  
Abundant Cytoplasm ◽  
History Of

Prostatic acinar adenocarcinoma (PAA) is the most common malignant tumour of the male genital system. Hormonal therapy and radiotherapy are widely-used treatment modalities in advanced stage disease. However, with hormonal therapy, the morphology of the neoplastic cells can be altered with a shift towards benign-appearing cells with inconspicuous nucleoli and abundant cytoplasm. When the tumour spreads to the bone marrow, these neoplastic cells can mimic foamy histiocytes, which may lead to a misdiagnosis. This becomes more challenging if a concurrent bone marrow malignancy is identified. Attention should be paid if foamy cells are detected in bone marrow, particularly if the patient has a history of PAA. To the best of our knowledge, this is the first report of simultaneous bone marrow involvement by metastatic PAA with mimicking foamy histiocytes and lymphoplasmacytic lymphoma.

Erythropoietin for the treatment of anemia of malignancy associated with neoplastic bone marrow infiltration.

1990 ◽  
Vol 8 (6) ◽  
pp. 956-962 ◽  
Author(s):  
W Oster ◽  
F Herrmann ◽  
H Gamm ◽  
G Zeile ◽  
A Lindemann ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bolus Injection ◽  
Bone Marrow Involvement ◽  
Serum Levels ◽  
Underlying Disease ◽  
Bone Marrow Infiltration ◽  
Low Grade ◽  
History Of ◽  
Neoplastic Lymphocytes ◽  
Rbc Count

This clinical trial was performed to study the effects of intravenously (IV) administered recombinant human (rh) erythropoietin (EPO) at escalating doses (150, 300, and 450 U/kg, administered as an IV bolus injection, twice weekly, for 6, 4, and 4 weeks, respectively) in five patients with low-grade non-Hodgkin's lymphoma (Ig NHL) and bone marrow involvement and one patient with multiple myeloma (MM). All patients were anemic due to underlying disease. None of the patients had a history of bleeding, hemolysis, renal insufficiency, or other disorders causing anemia in addition to bone marrow infiltrating malignancy. Endogenous EPO serum levels were significantly increased in all patients (74 to 202 mU/mL). Five patients (one MM, four small-cell lymphocytic [SCLC] NHL) showed a dramatic increase of hemoglobin (Hb), hematocrit (Hk) and RBC count becoming obvious on the second EPO dose level. Initial ferritin serum values, which were high mostly due to polytransfusion, were significantly reduced in responding patients. Erythropoiesis of one patient with extensive follicular mixed (fm) NHL did not respond to EPO treatment. Platelet (PLT) count increase (greater than 75% above starting levels) during and following EPO therapy was observed in one patient with MM. Adverse events due to EPO therapy have not been recorded. These findings point out a previously unrecognized capacity of EPO given at pharmacologic doses to stimulate erythropoiesis in patients with anemia due to bone marrow infiltration by neoplastic lymphocytes in spite of enhanced endogenous EPO expression.

scholarly journals Mantle Cell Lymphoma Presenting as a Subcutaneous Mass of the Right Leg

2020 ◽  
Vol 13 (2) ◽  
pp. 774-782
Author(s):  
Drew A. Fajardo ◽  
Joel France ◽  
Bogna I. Targonska ◽  
H. Bobby Kahlon ◽  
Max J. Coppes
Keyword(s):  
Bone Marrow ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Mantle Cell ◽  
History Of ◽  
Subcutaneous Mass ◽  
Systemic Symptoms ◽  
The Right

Mantle cell lymphoma (MCL) is a relatively rare B-cell non-Hodgkin lymphoma, typically presenting with extensive lymphadenopathy, bone marrow involvement, and splenomegaly. Extranodal sites can also be involved. We discuss a 73-year-old man whose MCL presented with a 6-month history of a subdermal mass of the right upper thigh and no systemic symptoms.

The Clinical Impact of Minimal Bone Marrow Involvement on the Outcome of Patients with Follicular Lymphoma

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2966-2966
Author(s):  
Daisuke Kato ◽  
Satoshi Yoshioka ◽  
Tomohiro Yabushita ◽  
Yoshimitsu Shimomura ◽  
Yuichiro Ono ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Follicular Lymphoma ◽  
Bone Marrow Involvement ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Morphological Evidence ◽  
Stage Disease ◽  
Igh Rearrangement ◽  
The Impact ◽  
Index Table

Abstract Introduction: Follicular lymphoma (FL) is the second most common type of non-Hodgkin cell lymphoma, and usually manifests as a disseminated disease. Bone marrow (BM) involvement, which occurs in 40-70% of cases, is often seen in follicular lymphoma and thought to be associated with less favorable prognosis. Diagnosis of BM involvement has traditionally been based on morphological findings, and BM involvement has been determined using histology alone in most clinical trials. Immunocytologic or molecular studies, such as flow cytometry (FCM) and polymerase chain reaction (PCR), have become more readily available, and their usage has clearly documented minimal BM involvement reproducibly. In this study, we evaluated the impact of BM involvement detected by FCM and PCR on the outcome of patients treated for FL. Methods: Patients who were diagnosed with biopsy-proven FL between 2004 and 2015 at our institution were included in the study. All patients had received a staging bone marrow examination before treatment with immunotherapy-based regimen. Immunocytologic [FCM] and/or molecular [PCR] studies were always performed if the patients did not have morphological BM involvement. We used 4- or 6- color FCM, and performed PCR analysis of Bcl-2/IgH rearrangement and/or IgH rearrangement detected by modified BioMed-2 protocol. A total of 90 patients were included, and the median follow-up duration was 36 months (range, 6|122 months). The BM status was classified using into 3 categories: morphological, minimal, and negative BM involvement. Minimal BM involvement was defined as BM involvement detected by FCM or PCR without morphological evidence. Morphological and minimal BM involvements were detected in 37 (41%) and 38 (42%) patients, respectively. The primary outcome measure was progression-free survival (PFS). PFS curves were plotted using the Kaplan-Meier method and compared by the log-rank test. Multivariate analyses were performed using a Cox linear regression model. There were significant differences in gender, LDH levels, stage, nodal sites, and FL International Prognostic Index (FLIPI) between patients with and without morphological BM involvement (Table1). Results: The 3-year PFS rate for patients with negative BM involvement was significantly better than that for patients with minimal or morphological BM involvement (84.8% vs. 40.3% vs. 60.5%; p= 0.043) (Figure 1). There was no statistical difference in 3-year PFS between patients with morphological BM involvement and those with minimal BM involvement. The difference of 3-year PFS rate between patients with minimal BM involvement and those with negative BM involvement was significant for patients with FLIPI low-intermediate risk (88.9% vs. 51.5%; p= 0.032) and those with advanced stage disease (90.0% vs. 33.6%; p= 0.027), but there were no significant differences in patients deemed FLIPI high risk and those with limited stage disease. Multivariate analysis revealed that BM involvement, including morphological and minimal involvement, was a significant poor prognostic factor (hazard ratio 4.885 [95% confidence interval 1.16-20.56], p = 0.0305). Conclusion: At the start of treatment, bone marrow involvement was seen in most FL patients. Patients without any BM involvement had an excellent prognosis. Patients with minimal BM involvement had an equally poor prognosis as those with morphologic BM involvement. Table 1 FLIPI: Follicular Lymphoma International Prognostic Index Table 1. FLIPI: Follicular Lymphoma International Prognostic Index Table 2 BM state positive: including morphological and minimal bone marrow involvement. Table 2. BM state positive: including morphological and minimal bone marrow involvement. Figure Figure. Disclosures Ishikawa: Mundipharma KK: Research Funding.

Survival after Autologous Transplantation to Treat Diffuse Large B-Cell Lymphoma with a History of CNS Involvement, Bone Marrow Involvement, or Histologic Transformation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5237-5237
Author(s):  
Brandon Hayes-Lattin ◽  
Pritesh Mehta ◽  
Adam Dunn ◽  
Nan Subbiah ◽  
Jose F. Leis ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
Autologous Transplantation ◽  
B Cell Lymphoma ◽  
Cns Involvement ◽  
Large B Cell Lymphoma ◽  
History Of ◽  
Large B Cell

Abstract Background: Patients with diffuse large B-cell lymphoma (DLBCL) who present with extra-nodal involvement or histologic transformation from low-grade disease have lower rates of survival after conventional-dose therapy. The impact of these features on outcomes after high-dose therapy with autologous transplantation was investigated. Methods: We retrospectively reviewed the outcomes of 64 consecutive patients receiving autologous transplantation from 1995 to 2003 for the treatment of DLBCL. Variables considered were age, gender, histologic transformation, history of bone marrow involvement, history of central nervous system (CNS) involvement, time from diagnosis to transplant, number of pre-transplant regimens, chemosensitivity prior to transplant, conditioning regimen, year of transplant, and the use of peripheral blood or bone marrow stem cells. Survivals were estimated by the Kaplan-Meier method. The Cox proportional hazards regression model was used to test the significance of factors on survival. Univariate association between variables and survival were tested by the log-rank test. Correlation between variables was tested with Spearman’s rank coefficient. Results: The median age at transplant among 64 patients was 53.5 years (17–74). The median overall survival was 3.3 years. Among these patients, 12 had a history of CNS involvement, 10 had a history of bone marrow involvement, and 12 had transformed from low-grade lymphoma. A Cox regression model suggested age <50 (log-rank, p=0.093), <2 regimens prior to transplant (log-rank, p=0.052), and the lack of BEAM as conditioning regimen (log-rank, p=0.019) as multivariate factors for survival. However, the use of BEAM was highly associated with older age (R²= 0.42, p=0.001) and more prior chemotherapy regimens (R²=0.24, p=0.054). A history of extranodal involvement, including prior CNS involvement (p=0.842) or bone marrow involvement (p=0.518), was not associated with lower survival by univariate analysis. No significant association was found between survival and a history of transformation (p=0.484). Conclusions: A history of CNS involvement, bone marrow involvement, or histologic transformation is not associated with lower rates of survival among patients undergoing autologous transplantation for diffuse large B-cell lymphoma at our institution. Patients who present with such histories remain candidates for autologous transplantation.

Intravascular Lymphomatosis With Bone Marrow Involvement

1999 ◽  
Vol 123 (10) ◽  
pp. 952-956
Author(s):  
Tammy J. Tucker ◽  
Ricardo H. Bardales ◽  
Roberto N. Miranda
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Bone Marrow Involvement ◽  
Immunohistochemical Analysis ◽  
Systematic Search ◽  
Cell Marker ◽  
Review Of The Literature ◽  
Neoplastic Cells ◽  
Laboratory Findings ◽  
Intravascular Lymphomatosis

Abstract We describe the case of a 56-year-old man who presented with numbness and tingling of the extremities, weakness, and fatigue. Laboratory findings included anemia and thrombocytopenia. A diagnosis of intravascular lymphomatosis was established when liver, omentum, and bone marrow samples were examined. A review of the literature reveals that most cases of intravascular lymphomatosis have cytopenias, mainly anemia and thrombocytopenia, but bone marrow involvement is rare. In our case, a subtle neoplastic infiltrate in the marrow sinusoids was highlighted with a B-cell marker. While immunohistochemical analysis was not performed in most reported cases in the literature, our studies suggest that a systematic search in bone marrow of cases of intravascular lymphomatosis may reveal unsuspected neoplastic cells. We conclude that bone marrow involvement in intravascular lymphomatosis appears to be rare, has subtle features, and is difficult to diagnose if unsuspected and not searched for.

The use of bone marrow aspirations and lumbar punctures at the time of diagnosis of retinoblastoma.

1989 ◽  
Vol 7 (1) ◽  
pp. 140-143 ◽  
Author(s):  
C B Pratt ◽  
D Meyer ◽  
P Chenaille ◽  
D B Crom
Keyword(s):  
Bone Marrow ◽  
Tumor Cells ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Stage Disease ◽  
Tumor Dissemination ◽  
Systemic Spread ◽  
Response To Chemotherapy ◽  
Tumor Involvement ◽  
Work Up

Lumbar punctures (n = 115) and bone marrow aspirations (n = 114) were performed as part of the routine initial diagnostic evaluation of 115 children with retinoblastoma. Three spinal fluid examinations were positive for tumor cells, and bone marrow smears of three children demonstrated clumps of tumor cells. Five of the six positive studies were in patients with stage IV (extraglobar) disease. These results show that demonstrable CSF or bone marrow involvement is so infrequent an event at diagnosis in patients without symptoms, signs, or histologic evidence of tumor dissemination (stages I-II) as to support a recommendation that these studies need not be performed routinely in such patients. If, after enucleation, there is evidence of extraglobar extension, or if patients have symptoms or signs of CNS or systemic spread (stages III or IV), both procedures should be performed to accurately stage disease and provide baseline measurements of tumor involvement for monitoring of response to chemotherapy and/or irradiation. These results have importance in terms of justification of invasive work-up of most (greater than 85%) affected children, and cost containment.

scholarly journals Histiocytic Sarcoma of Bone Marrow With Partial Cohesive Neoplastic Cells and Hemophagocytosis: a Case Report

2021 ◽  
Author(s):  
Yang Liang ◽  
Li Mao ◽  
Yihua Chen ◽  
Guangjie Wang
Keyword(s):  
Bone Marrow ◽  
Tumor Cells ◽  
Hemophagocytic Syndrome ◽  
Histiocytic Sarcoma ◽  
Neoplastic Cells ◽  
Case Presentation ◽  
Barr Virus ◽  
History Of ◽  
Epstein Barr ◽  
Aggressive Clinical Course

Abstract Background: Histiocytic sarcoma (HS) is a rare hematolymphoid neoplasms whose cells show morphologic and immunophenotypic features of mature tissue histiocytes. We herein report a HS case without nodules or lymphadenectasis confirmed with the help of immunohistochemistry (IHC) on bone marrow (BM) biopsy and smear.Case presentation: A 63-year-old female patient with a history of cerebral infarction presented with fever, retching and hypodynamic sign for three weeks. The peripheral blood examination showed aggressive pancytopenia accompanying with the positivity for Epstein-Barr virus (EBV) antibody. The computed tomography and abdomen ultrasound scan didn’t reveal any nodules or lymphadenectasis other than hypersplenotrophy. Significantly, the BM aspirate shows vast pleomorphic tumor cells atypically distributed in both forms of single diffuse and cohesive. The hemophagocyte phagocytized granulocytes on BM smear exhibited the lymphoma related hemophagocytic syndrome. Immunohistochemically, neoplastic cells were immunopositively for macrophage-associated antigen cluster of CD4, CD68, CD163, but negative for the T-cell, B-cell and myeloid lineage markers of CD15, CD20, PAX-5, CD5, CD30, CD3, CD56, CD38, CD138, ALK and MPO, confirming the hypothesis of HS in BM. Conclusion: The rare HS case of bone marrow with atypically partial cohesive pleomorphic tumor cells had the hemophagocytic syndrome, presented highly aggressive clinical course and challenged to the diagnoses.

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