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Kemik İliği Biyopsisi ile Tanı Alan Karsinom Metastazlı Hastalarımız

Yıl 2022, , 211 - 216, 28.02.2022
https://doi.org/10.20515/otd.997795

Öz

Solid tümörlerin kemik iliğinde tutulum yaptığı bilinmektedir. Ancak kemik iliği tutulumu ile tanı alması nadirdir. Klinik ve laboratuvar bulguları karakteristik değildir ve farklı ön tanıların düşünülmesine yol açabilmektedir. Kemik iliğinde tutulum saptandığı zaman tedavi yaklaşımını da etkilemekte ve kötü prognozla ilişkilidir. AMAÇ: Kemik iliği tutulumu ile tanı alan solid tümörlü hastalarımızın klinik ve laboratuvar özelliklerini anlatmayı amaçladık. MATERYAL- METOD: Hematolojik malignite ön tanısı ile kemik iliği biyopsisi yapılan ve karsinom metastazı tanısı alan 7 hasta retrospektif olarak değerlendirildi. 3’ü erkek, 4’ü kadın hastanın median tanı yaşı 71 idi. Ortalama tanı yaşı 61,2±19,9 idi. 6 hasta halsizlik, 2 hasta nefes darlığı, 1 hasta da iştahsızlık şikayeti ile başvurmuştu. Hastaların hepsinde anemi, 6 hastada trombositopeni, 6 hastada eritrosit sedimentasyon hızı (ESH) yüksekliği, 3 hastada lökositoz mevcut idi. 4 hastada meme kanseri, 2 hastada mide, 1 hastada prostat karsinom tutulumu saptandı. Tanı konan hastaların median sağ kalım süreleri 20 ay (2-33 ay) olarak saptanmıştır. 2 meme kanseri ve 1 prostat kanserli hasta hormonoterapi ile yaşamlarını sürdürmektedirler. SONUÇ: Kemik iliği biyopsisi; kemik iliğinde tutulum yapan hastalıkları saptamada ucuz, kolay uygulanabilen ve etkin bir yöntemdir.

Kaynakça

  • Krishnan C, George TI, Arber DA. Bone marrow metastases: a survey of nonhematologic metastases with immunohistochemical study of metastatic carcinomas. Appl Immunohistochem Mol Morphol 2007; 15: 1–7.
  • Sharma S, Murari M. Bone marrow involvement by metastatic solid tumors. Indian J Pathol Microbiol 2003; 46: 382–384 .
  • Sterling JA, Edwards JR, Martin TJ, Mundy GR. Advances in the biology of bone metastasis: how the skeleton affects tumor behavior. Bone. 2011 ;48(1):6-15.
  • Banys M, Solomayer EF, Becker S, Krawczyk N, Gardanis K, Staebler A, Neubauer H, Wallwiener D, Fehm T. Disseminated tumor cells in bone marrow may affect prognosis of patients with gynecologic malignancies. Int J Gynecol Cancer. 2009;19(5):948-52.
  • Kuchuk I, Hutton B, Moretto P, Ng T, Addison CL, Clemons M. Incidence, consequences and treatment of bone metastases in breast cancer patients-experience from a single cancer centre. J Bone Oncol (2013) 2(4):137–44.
  • Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001; 27(3):165–76.
  • Kiliçkap, S., Erman, M., Dınçer, M., Aksoy, S., Harputluoğlu, H., & Yalçin, Ş. (2007). Bone marrow metastasis of solid tumors: Clinicopathological evaluation of 73 cases. Turkish Journal of Cancer, 2007;37(3), : 85–88.
  • Wong KF, Chan JK, Ma SK: Solid tumour with initial presentation in the bone marrow—a clinicopathologic study of 25 adult cases. Hematol Oncol. 1993, 11:35-42.
  • Xiao L, Luxi S, Ying T, Yizhi L, Lingyun W, Quan P: Diagnosis of unknown nonhematological tumors by bone marrow biopsy: a retrospective analysis of 10,112 samples. J Cancer Res Clin Oncol. 2009, 135:687-693.
  • Fei Y, Jia-cheng X, Xiao-long J et al. Pathologic diagnosis of bone marrow biopsy for metastatic carcinomas. J Shanghai Jiaotong Univ Med Sci 2006; 26:444–447.
  • Kucukzeybek BB, Calli AO, Kucukzeybek Y, Bener S, Dere Y, Dirican A, Payzin KB, Ozdemirkiran F, Tarhan MO. The prognostic significance of bone marrow metastases: evaluation of 58 cases. Indian J Pathol Microbiol. 2014 ;57(3):396-9.
  • Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000 ;13(9):962-72.
  • Kitamura H, Yazawa T, Sato H, Okudela K, Shimoyamada H. Small cell lung cancer: significance of RB alterations and TTF-1 expression in its carcinogenesis, phenotype, and biology. Endocr Pathol. 2009 ;20(2):101-7.
  • Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, Eeles RA, Ford LG, Hamdy FC, Holmberg L, Ilic D, Key TJ, La Vecchia C, Lilja H, Marberger M, Meyskens FL, Minasian LM, Parker C, Parnes HL, Perner S, Rittenhouse H, Schalken J, Schmid HP, Schmitz-Dräger BJ, Schröder FH, Stenzl A, Tombal B, Wilt TJ, Wolk A. Prevention and early detection of prostate cancer. Lancet Oncol. 2014;15(11):484-92.
  • Mostofi FK, Davis CJ Jr, Sesterhenn IA. Pathology of carcinoma of the prostate. Cancer. 1992;70(1):235-53.
  • Chernow B, Wallner SF. Variables predictive of bone marrow metastasis. Cancer. 1978 N;42(5):2373-8.
  • Chauhan K, Jain M, Grover S, Shukla P, Rusia U, Grover RK. Bone marrow metastasis in nonhematologic malignancies: Data from a cancer hospital. Clin Cancer Investig J 2016;5:103-9.
  • Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, Evrensel T, Yerci O, Tunali A. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer. 2005;5:144.
  • Chou WC, Yeh KY, Peng MT, Chen JS, Wang HM, Lin YC, Liu CT, Li SH, Chang PH, Wang CH, Chen PT, Hung YS, Lu CH. Development and Validation of a Prognostic Score to Predict Survival in Adult Patients With Solid Tumors and Bone Marrow Metastases. Medicine (Baltimore). 2015 ;94(23):966.
  • Gaiolla RD, Duarte ÍX, Bacchi CE, Paiva CE. A metastatic ovarian angiosarcoma mimicking hematologic neoplasia at diagnosis. Case Rep Oncol 2014;7:260–265.
  • H. G. Kopp, K. Krauss, T. Fehm et al., “Symptomatic bone marrow involvement in breast cancer – clinical presentation, treatment, and prognosis: a single institution review of 22 cases,” Anticancer Research, 2011;31(11): 4025–4030.
  • L. Demir, M. Akyol, S. Bener et al., “Prognostic evaluation of breast cancer patients with evident bone marrow metastasis,”The Breast Journal,2014;20(3):279–287.
  • Rundles RW, Jonsson U. Metastases in bone marrow and myelophthisic anemia from carcinoma of the prostate. Am J Med Sci 1949;218: 242-250.
  • Shah NT, Tuttle SE, Strobel SL, Gandhi L. Prostatic carcinoma metastatic to bone: sensitivity and specificity of prostate specific antigen and prostatic acid phosphatase in decalcified material. J Surg Oncol 1985;29: 265-268.
  • Kamby C, Guldhammer B, Vejborg I, Rossing N, Dirksen H, Daugaard S and Mouridsen HT: The presence of tumor cells in bone marrow at the time of first recurrence of breast cancer. Cancer 1987; 60: 1306-1312.
  • H. G. Kopp, K. Krauss, T. Fehm et al., “Symptomatic bone marrow involvement in breast cancer – clinical presentation, treatment, and prognosis: a single institution review of 22 cases,” Anticancer Research,2011;31(11):4025–4030.

Patients with Carcinoma Metastasis Diagnosed By Bone Marrow Biopsy

Yıl 2022, , 211 - 216, 28.02.2022
https://doi.org/10.20515/otd.997795

Öz

It is known that solid tumors are involved in the bone marrow. However, it is rare to be diagnosed with bone marrow involvement. Clinical and laboratory findings are not characteristic and may lead to the consideration of different prediagnoses. When bone marrow involvement is detected, it also affects the treatment approach and is associated with a poor prognosis. We aimed to describe the clinical and laboratory characteristics of our patients with solid tumors diagnosed with bone marrow involvement. Seven patients who underwent bone marrow biopsy with the pre-diagnosis of hematological malignancy and were diagnosed with carcinoma metastasis were evaluated retrospectively. The median age at diagnosis of 3 male and 4 female patients was 71. The mean age at diagnosis was 61,2±19,9. 6 patients presented with fatigue, 2 patients with shortness of breath, and 1 patient with anorexia. All patients had anemia, 6 patients had thrombocytopenia, 6 patients had increased sedimentation, and 3 patients had leukocytosis. Breast cancer in 4 patients, gastric carcinoma in 2 patients, and prostate carcinoma in 1 patient were detected. The median survival time of the diagnosed patients was 20 months (2-33 months). 2 breast cancer and 1 prostate cancer patients continue their lives with hormone therapy. Bone marrow biopsy; is a cheap, easily applicable and effective method for detecting diseases involving the bone marrow.

Kaynakça

  • Krishnan C, George TI, Arber DA. Bone marrow metastases: a survey of nonhematologic metastases with immunohistochemical study of metastatic carcinomas. Appl Immunohistochem Mol Morphol 2007; 15: 1–7.
  • Sharma S, Murari M. Bone marrow involvement by metastatic solid tumors. Indian J Pathol Microbiol 2003; 46: 382–384 .
  • Sterling JA, Edwards JR, Martin TJ, Mundy GR. Advances in the biology of bone metastasis: how the skeleton affects tumor behavior. Bone. 2011 ;48(1):6-15.
  • Banys M, Solomayer EF, Becker S, Krawczyk N, Gardanis K, Staebler A, Neubauer H, Wallwiener D, Fehm T. Disseminated tumor cells in bone marrow may affect prognosis of patients with gynecologic malignancies. Int J Gynecol Cancer. 2009;19(5):948-52.
  • Kuchuk I, Hutton B, Moretto P, Ng T, Addison CL, Clemons M. Incidence, consequences and treatment of bone metastases in breast cancer patients-experience from a single cancer centre. J Bone Oncol (2013) 2(4):137–44.
  • Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001; 27(3):165–76.
  • Kiliçkap, S., Erman, M., Dınçer, M., Aksoy, S., Harputluoğlu, H., & Yalçin, Ş. (2007). Bone marrow metastasis of solid tumors: Clinicopathological evaluation of 73 cases. Turkish Journal of Cancer, 2007;37(3), : 85–88.
  • Wong KF, Chan JK, Ma SK: Solid tumour with initial presentation in the bone marrow—a clinicopathologic study of 25 adult cases. Hematol Oncol. 1993, 11:35-42.
  • Xiao L, Luxi S, Ying T, Yizhi L, Lingyun W, Quan P: Diagnosis of unknown nonhematological tumors by bone marrow biopsy: a retrospective analysis of 10,112 samples. J Cancer Res Clin Oncol. 2009, 135:687-693.
  • Fei Y, Jia-cheng X, Xiao-long J et al. Pathologic diagnosis of bone marrow biopsy for metastatic carcinomas. J Shanghai Jiaotong Univ Med Sci 2006; 26:444–447.
  • Kucukzeybek BB, Calli AO, Kucukzeybek Y, Bener S, Dere Y, Dirican A, Payzin KB, Ozdemirkiran F, Tarhan MO. The prognostic significance of bone marrow metastases: evaluation of 58 cases. Indian J Pathol Microbiol. 2014 ;57(3):396-9.
  • Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000 ;13(9):962-72.
  • Kitamura H, Yazawa T, Sato H, Okudela K, Shimoyamada H. Small cell lung cancer: significance of RB alterations and TTF-1 expression in its carcinogenesis, phenotype, and biology. Endocr Pathol. 2009 ;20(2):101-7.
  • Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, Eeles RA, Ford LG, Hamdy FC, Holmberg L, Ilic D, Key TJ, La Vecchia C, Lilja H, Marberger M, Meyskens FL, Minasian LM, Parker C, Parnes HL, Perner S, Rittenhouse H, Schalken J, Schmid HP, Schmitz-Dräger BJ, Schröder FH, Stenzl A, Tombal B, Wilt TJ, Wolk A. Prevention and early detection of prostate cancer. Lancet Oncol. 2014;15(11):484-92.
  • Mostofi FK, Davis CJ Jr, Sesterhenn IA. Pathology of carcinoma of the prostate. Cancer. 1992;70(1):235-53.
  • Chernow B, Wallner SF. Variables predictive of bone marrow metastasis. Cancer. 1978 N;42(5):2373-8.
  • Chauhan K, Jain M, Grover S, Shukla P, Rusia U, Grover RK. Bone marrow metastasis in nonhematologic malignancies: Data from a cancer hospital. Clin Cancer Investig J 2016;5:103-9.
  • Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, Evrensel T, Yerci O, Tunali A. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer. 2005;5:144.
  • Chou WC, Yeh KY, Peng MT, Chen JS, Wang HM, Lin YC, Liu CT, Li SH, Chang PH, Wang CH, Chen PT, Hung YS, Lu CH. Development and Validation of a Prognostic Score to Predict Survival in Adult Patients With Solid Tumors and Bone Marrow Metastases. Medicine (Baltimore). 2015 ;94(23):966.
  • Gaiolla RD, Duarte ÍX, Bacchi CE, Paiva CE. A metastatic ovarian angiosarcoma mimicking hematologic neoplasia at diagnosis. Case Rep Oncol 2014;7:260–265.
  • H. G. Kopp, K. Krauss, T. Fehm et al., “Symptomatic bone marrow involvement in breast cancer – clinical presentation, treatment, and prognosis: a single institution review of 22 cases,” Anticancer Research, 2011;31(11): 4025–4030.
  • L. Demir, M. Akyol, S. Bener et al., “Prognostic evaluation of breast cancer patients with evident bone marrow metastasis,”The Breast Journal,2014;20(3):279–287.
  • Rundles RW, Jonsson U. Metastases in bone marrow and myelophthisic anemia from carcinoma of the prostate. Am J Med Sci 1949;218: 242-250.
  • Shah NT, Tuttle SE, Strobel SL, Gandhi L. Prostatic carcinoma metastatic to bone: sensitivity and specificity of prostate specific antigen and prostatic acid phosphatase in decalcified material. J Surg Oncol 1985;29: 265-268.
  • Kamby C, Guldhammer B, Vejborg I, Rossing N, Dirksen H, Daugaard S and Mouridsen HT: The presence of tumor cells in bone marrow at the time of first recurrence of breast cancer. Cancer 1987; 60: 1306-1312.
  • H. G. Kopp, K. Krauss, T. Fehm et al., “Symptomatic bone marrow involvement in breast cancer – clinical presentation, treatment, and prognosis: a single institution review of 22 cases,” Anticancer Research,2011;31(11):4025–4030.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Filiz Yavaşoğlu 0000-0002-4017-4668

Çiğdem Özdemir 0000-0001-8500-0744

Yayımlanma Tarihi 28 Şubat 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

Vancouver Yavaşoğlu F, Özdemir Ç. Kemik İliği Biyopsisi ile Tanı Alan Karsinom Metastazlı Hastalarımız. Osmangazi Tıp Dergisi. 2022;44(2):211-6.


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