Bone marrow metastases: A survey of nonhematologic metastases with immunohistochemical study of metastatic carcinomas
ABSTRACT With current therapies and imaging methods, staging bone marrow biopsies, and subsequently found metastases to the bone marrow, are less frequent. Historically, the most common metastatic nonhematologic tumors to the bone marrow in adult and pediatric patients included breast carcinoma, neuroblastoma, prostatic carcinoma, Ewing sarcoma, and lung tumors. Although the staining patterns of these primary tumors have been extensively examined, the utility of these immunohistochemical profiles has not been studied in the context of metastatic lesions to the bone marrow. In our review of 111 metastases to the bone marrow over an 18-year period, the most common primary tumor types are, in order of frequency: breast carcinoma, neuroblastoma, lung tumors, rhabdomyosarcoma, Ewing sarcoma, prostate carcinoma, and gastrointestinal tract tumors. Additionally, in an analysis of 44 adult metastatic carcinomas, we confirm that immunohistochemical panels are useful in identifying the primary tumor site. Overall, the immunohistochemical characterization of metastatic carcinomas to the bone marrow show good correlation with the established staining pattern of the primary tumors.
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ABSTRACT: Primary bronchial mucoepidermoid carcinoma in the lung is relatively rare. It rarely presents with the highly malignant biological characteristic of bone marrow metastasis. We describe a case of this disease with bone marrow metastasis. A 56-year-old man with the primary manifestation of bone pain and bloodstained sputum had two abnormal shadows on the left inferior lobar bronchus and peripheral tissue of the lower lobe of the left lung, respectively. Computed tomography-guided percutaneous puncture biopsy and bone imaging confirmed the diagnosis of high-grade bronchial mucoepidermoid carcinoma with bone metastasis. However, the patient soon presented with progressive hemoglobin and platelet decline and severe multi-organ hemorrhage. Subsequently, we performed bone marrow aspiration and biopsy, which revealed malignant cells and necrosis. The patient deteriorated rapidly from the disease, and died on the 16th day of admission. We hope that this case report will increase awareness of the possibility of primary high-grade bronchial mucoepidermoid carcinoma metastasizing to the bone marrow, which might be a poor prognostic factor.World Journal of Surgical Oncology 05/2014; 12(1):158. DOI:10.1186/1477-7819-12-158 · 1.20 Impact Factor
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ABSTRACT: 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.11/2014; 8(11-12):E941-3. DOI:10.5489/cuaj.2402
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ABSTRACT: Introduction: Adipocytes and their products play essential roles in tumor establishment and progression. As the main cellular component of the bone marrow, adipocytes may contribute to the development of hematologic tumors.Areas covered: This review summarizes experimental data on adipocytes and their interaction with various cancer cells. Special focus is set on the interactions of bone marrow adipocytes and normal and transformed cells of the hematopoietic system such as myeloma and leukemia cells. Current in vitro and in vivo data are summarized and the potential of novel therapeutic targets is critically discussed.Expert opinion: Targeting lipid metabolism of cancer cells and adipocytes in combination with standard therapeutics might open novel therapeutic avenues in these cancer entities. Adipocyte-derived products such as free fatty acids and specific adipokines such as adiponectin may be vital anti-cancer targets in hematologic malignancies. However, available data on lipid metabolism is currently mostly referring to peripheral fat cell/cancer cell interactions and results need to be evaluated specifically for the bone marrow niche.Expert Opinion on Biological Therapy 10/2014; 15(1). DOI:10.1517/14712598.2015.970632 · 3.65 Impact Factor