Korean J Lab Med.  2007 Apr;27(2):96-101. 10.3343/kjlm.2007.27.2.96.

Laboratory Evaluation of Bone Marrow Metastasis: Single Institute Study

Affiliations
  • 1Department of Laboratory Medicine, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Korea. mgshin@chonnam.ac.kr
  • 2Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University in 2006, Gwangju, Korea.

Abstract

BACKGROUND: The incidence of bone marrow (BM) metastasis might be related with the occurrence of malignant tumors in ethnic groups. So, we investigated the type and the frequency of metastatic tumors of BM and analyzed the clinicopathologic variables of BM metastasis. METHODS: This study included 932 cases of primary malignant tumor which were requested for BM study from January 1995 to June 2006 in Chonnam National University Hospital and Chonnam National University Hwasun Hospital. Peripheral blood smears (PBS); aspirates, touch prints, and trephine biopsies of BM; and medical records including other laboratory test results were reviewed. RESULTS: Overall frequency of BM metastasis was 11.9% (111/932). Primary tumors with BM involvement in children comprised neuroblastoma (74.1%), rhabdomyosarcoma (7.4%), and malignant lymphoma (7.4%). For adult patients, they consisted of malignant lymphoma (56.0%), gastrointestinal cancer (20.2%), and lung cancer (6.0%). In the case of malignant lymphoma, diffuse large cell lymphoma was the most frequent one. Laboratory findings of patients with BM metastasis commonly showed anemia and thrombocytopenia; in addition, serum LD, ALP, AST and ALT were elevated in 81.5% (75/92), 63.4% (59/93), 63.5% (61/96) and 33.3% (32/96), respectively. Leukoerythroblastosis was observed only in 19.8% (22/111) on PBS examination. CONCLUSIONS: The most common non-hematopoietic metastatic tumor was neuroblastoma in children and gastrointestinal tumors in adults. Leukoerythroblastosis, anemia, and the elevation of serum LD, ALP, and AST were useful markers for the prediction of BM metastasis.

Keyword

Bone marrow; Metastasis; Malignant tumor

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Bone Marrow Examination
Bone Marrow Neoplasms/diagnosis/pathology/*secondary
Child
Child, Preschool
Female
Gastrointestinal Neoplasms/pathology
Hematologic Tests
Humans
Infant
Male
Middle Aged
Neuroblastoma/pathology

Reference

References

1. Anner RM, Drewinko B. Frequency and significance of bone marrow involvement by metastatic solid tumors. Cancer. 1977; 39:1337–44.
Article
2. Cotta CV, Konoplev S, Medeiros LJ, Bueso-Ramos CE. Metastatic tumors in bone marrow: histopathology and advances in the biology of the tumor cells and bone marrow environment. Ann Diagn Pathol. 2006; 10:169–92.
Article
3. Chernow B, Wallner SF. Variables predictive of bone marrow metastasis. Cancer. 1978; 42:2373–8.
Article
4. Park SH, Lee SJ, Hahn JS, Ko YW, Kim BS. A study on the criteria predictive of bone marrow metastasis. Korean J Intern Med. 1987; 32:721–30.
5. Byun DE, Suh SP, Ryang DW. Hematologic evaluation of bone marrow metastasis in Korea. Korean J Clin Pathol. 1992; 12:33–41.
6. John FN, Michael AP. Reference range for laboratory tests and procedures. Behrman RE, Kliegman RM, editors. Nelson textbook of pediatrics. 17th ed.Philadelphia: WB Saunders;2004. p. 2396–426.
7. Moid F, DePalma L. Comparison of relative value of bone marrow aspirates and bone marrow trephine biopsies in the diagnosis of solid tumor metastasis and Hodgkin lymphoma: institutional experience and literature review. Arch Pathol Lab Med. 2005; 129:497–501.
Article
8. Reich C. A study of the diagnostic value of sternal puncture in clinical hematology. Am J Med Sci. 1935; 189:515–20.
Article
9. Terplan K, Vaughan SL. Primary carcinoma of the stomach-grossly unrecognizable with extensive metastasis to the bone marrow producing marked intravital erythroblastosis. Arch Pathol Lab Med. 1934; 18:924.
10. Vaughn JM, Oxon DM. Leukoerythroblastic anemia. J Pathol Bact. 1936; 42:541–64.
11. Contreras E, Ellis LD, Lee RE. Value of the bone marrow biopsy in the diagnosis of metastatic carcinoma. Cancer. 1972; 29:778–83.
Article
12. Pio SJ, Kim HK, Park SH, Kim CC, Lee KS, Kim DJ, et al. The hematologic findings in the cancer patients with bone marrow metastasis. Korean J Hematol. 1984; 19:243–8.
13. Shin MG, Kim YH, Ryang DW. Hematological evaluation of leukoerythroblastosis in Korean. Korean J Clin Pathol. 1992; 12:25–32.
14. Arber DA, George TI. Bone marrow biopsy involvement by non-Hodgkin's lymphoma: frequency of lymphoma types, patterns, blood involvement, and discordance with other sites in 450 specimens. Am J Surg Pathol. 2005; 29:1549–57.
15. Yoon JH, Park HS, Kim CW, Cho HI. Bone marrow involvement of malignant lymphoma. Korean J Hematol. 1993; 28:373–87.
16. Pakos EE, Fotopoulos AD, Ioannidis JP. 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a metaanalysis. J Nucl Med. 2005; 46:958–63.
17. Yun M, Kim YJ, Moon JW, Park SJ, Lee JD. Detection of lymphomatous marrow infiltration using F-18 FDG PET at initial staging and after chemotherapy. Korean J Nucl Med. 2003; 37:171–7.
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