The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases.
The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases.
复制标题
骨髓穿刺和活检诊断未怀疑的非血液恶性肿瘤：19 例临床研究。
DOI：
10.1186/1471-2407-5-144
复制
发表时间：
2005-11-01
期刊：
影响因子：
3.8
通讯作者：
Tunali, A
中科院分区：
文献类型：
--
作者：
Ozkalemkas, F;Ali, R;Ozkocaman, V;Ozcelik, T;Ozan, U;Ozturk, H;Kurt, E;Evrensel, T;Yerci, O;Tunali, A
虽然骨髓转移可以在一些恶性肿瘤中常见，但从骨髓诊断非血液系统恶性肿瘤并不是一件常见的事情。为了强调骨髓活检作为诊断播散性肿瘤的捷径的价值，我们回顾了19例最初由骨髓确诊的非血液性恶性肿瘤患者。骨髓检查的主要指征是微血管病理性溶血性贫血(MAHA)、白细胞增多症(LEB)和不明原因的红细胞减少症。6例因抽吸干燥或取材不足而不能确诊。除一例外，所有病例的活检结果均与细胞学结果平行；然而，仔细的第二次活检也证实了该患者的细胞学诊断。最常见的组织学亚型是腺癌，经过所有的临床和实验室评估，10例患者(胃5例，前列腺癌3例，肺1例，肌肉1例)明确了原发病灶，可能4例(胃肠道3例，肺1例)。所有检查均失败的有5名患者，这些病例被归类为来源不明的肿瘤(TOO)。本组病例经骨髓检查确诊为播散性肿瘤，表现为贫血、血小板减少、红细胞分布宽度(RDW)升高和低蛋白血症。除4例生存期较长外，其余患者预后较差，仅存活数天或数周。我们的结论是，MAHA、LEB和不明原因的细胞减少症是骨髓检查必要性的有力指标。由于许多患者的生存期很短，所有的研究程序都应该考虑到它们的合理性，并且应该把重点放在可治疗的原发肿瘤上。
Although bone marrow metastases can be found commonly in some malignant tumors, diagnosing a nonhematologic malignancy from marrow is not a usual event. To underscore the value of bone marrow aspiration and biopsy as a short cut in establishing a diagnosis for disseminated tumors, we reviewed 19 patients with nonhematologic malignancies who initially had diagnosis from bone marrow. The main indications for bone marrow examination were microangiopathic hemolytic anemia (MAHA), leukoerythroblastosis (LEB) and unexplained cytopenias. Bone marrow aspiration was not diagnostic due to dry tap or inadequate material in 6 cases. Biopsy results were parallel to the cytological ones in all cases except one; however a meticulous second examination of the biopsy confirmed the cytologic diagnosis in this patient too. The most common histologic subtype was adenocarcinoma, and after all the clinical and laboratory evaluations, the primary focus was disclosed definitively in ten patients (5 stomach, 3 prostate, 1 lung, 1 muscle) and probably in four patients (3 gastrointestinal tract, 1 lung). All work up failed in five patients and these cases were classified as tumor of unknown origin (TUO). Our series showed that anemia, thrombocytopenia, elevated red cell distribution width (RDW) and hypoproteinemia formed a uniform tetrad in patients with disseminated tumors that were diagnosed via bone marrow examination. The prognosis of patients was very poor and survivals were only a few days or weeks (except for 4 patients whose survivals were longer). We concluded that MAHA, LEB and unexplained cytopenias are strong indicators of the necessity of bone marrow examination. Because of the very short survival of many patients, all investigational procedures should be judged in view of their rationality, and should be focused on treatable primary tumors.
登录
查看更多内容
影响因子：
3.1
作者：
ATAC, B;LAWRENCE, C;GOLDBERG, SN
通讯作者：
GOLDBERG, SN
DOI：
10.1163/15685590152763755
发表时间：
2001-01-01
期刊：
HAEMATOLOGIA
影响因子：
--
作者：
Sari, R;Aydogdu, I;Buyukberber, S
通讯作者：
Buyukberber, S
影响因子：
12.8
作者：
HUMPHRIES, JE
通讯作者：
HUMPHRIES, JE
影响因子：
39.2
作者：
CAMPLING, B;QUIRT, I;EVANS, WK
通讯作者：
EVANS, WK
影响因子：
--
作者：
RINGENBERG, QS;DOLL, DC;PERRY, MC
通讯作者：
PERRY, MC