Bone marrow metastases - A 7 years study from a single tertiary centre in eastern India


Author(s): Sarita Pradhan, Rashmi Patnayak, Sukanya Patra, Rajesh Kumar Bhola, Soumya Surath Panda, Sima Chauhan4 riyanka Samal

Introduction: Haematogenous spread of tumours to bone marrow is a common phenomenon and implies advanced stage of disease with poor prognosis. In most instances, the site of primary malignancies is known and is demonstrated in the bone marrow, when the procedure is carried out as a part of the staging process. However In some cases, detection is incidental and bone marrow involvement may be the first clue to these unsuspected non haematopoietic malignancies. Objective: In this study, we aim to analyse the clinic-pathological spectrum of non-hematopoietic neoplasms detected in bone marrow biopsies carried out in our setting. Methods: This is a descriptive cross-sectional study, where the Laboratory Information System (LIS) was used to screen all the bone marrow trephine biopsies done over the last 7 years, from January 2014 to December 2020. Out of total 4370 bone marrow trephine biopsies performed, 53 cases of bone marrow metastases by nonhematopoeitic malignancies were detected. All the stained slides and the tissue blocks of metastases were retrieved for observation and their laboratory parameters were retrieved from the Laboratory Information System (LIS). Results: Out of these 53 cases, primary was known in 16 (30.2%) cases prior to performing marrow biopsies. 15 (28.3%) cases presented with severe backache and/or presence of lytic lesions on radiological examination and underwent marrow examination with a clinical suspicion of multiple myeloma verses metastases. 16 (30.2%) cases were incidentally detected while evaluating for causes of cytopenias and leucoerythroblastic blood picture. Adenocarcinoma prostate was the most common tumour with first presentation as bone marrow metastases followed by adenocarcinomatous deposits from gastrointestinal tract. Conclusion: Bone marrow metastases by non-hematopoietic neoplasms can be the first presenting feature in many cases as seen in our study. So, performing a trephine biopsy routinely along with aspiration for any unexplained cytopenias is of paramount importance in clinching the primary diagnosis.

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Editors List

  • Alireza Heidari

    Full Distinguished Professor and Academic Tenure of Chemistry and Enrico Fermi Distinguished Chair in Molecular Spectroscopy and Head of Cancer Research Institute (CRI) and Director of the BioSpectroscopy Core Research Laboratory (BCRL) at Faculty of Chemistry, California South University (CSU), Irvine, California, USA and President of the American International Standards Institute (AISI), Irvine, California, USA and Board Member of the World Association of Theoretical and Computational Chemists (WATOC)

  • DR. Prabira Kumar Sethy

    Department of Electronics, Sambalpur University


    Submitted PhD thesis in Biotechnology at GITAM University, Vizag.

  • Yousef Alomi

    Yousef Alomi
    The Past Head, General Administration of Pharmaceutical Care at Ministry of Health,
    Saudi Arabia Critical Care/TPN
    Clinical Pharmacist Ministry of Health,
    Riyadh, Saudi Arabia.

  • Osamu Tanaka

    Osamu Tanaka
    Assistant Professor,
    Department of Radiation Oncology
    Asahi University Hospital
    Gifu city, Gifu, Japan

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