Mahdi E J, Mahdi A J
Cardiff University School of Medicine, Cardiff, UK.
BMJ Case Rep. 2014 Jan 31;2014:bcr2013202612. doi: 10.1136/bcr-2013-202612.
The association of metastatic breast cancer presenting as thrombocytopenia and anaemia is demonstrated in the following case of a 79-year-old woman. Her main symptoms were abdominal pain, altered bowel habit and weight loss. Without a clear causative pathology, she underwent a CT scan which demonstrated multiple sclerotic bone lesions. With a raised CA15-3 and strong oestrogen receptor positivity on immunohistochemistry on a trephine bone marrow biopsy, a diagnosis of metastatic lobular breast cancer was made. Interestingly, only a small breast mass was noted on mammography. The patient was managed conservatively and initiated on supportive therapy. This case report summarises the varying presentation of bone marrow suppression secondary to metastatic infiltration, especially in the absence of classical symptoms associated with primary solid tumour. Accurate bone marrow analysis is also vital in establishing the final diagnosis.
以下是一位79岁女性的病例，该病例展示了转移性乳腺癌表现为血小板减少和贫血之间的关联。她的主要症状是腹痛、排便习惯改变和体重减轻。在没有明确病因病理的情况下，她接受了CT扫描，结果显示多处硬化性骨病变。通过对环钻骨髓活检进行免疫组织化学检测，发现CA15-3升高且雌激素受体呈强阳性，最终诊断为转移性小叶乳腺癌。有趣的是，乳房X光检查仅发现一个小乳房肿块。该患者接受了保守治疗，并开始进行支持性治疗。本病例报告总结了转移性浸润继发骨髓抑制的不同表现，尤其是在缺乏与原发性实体瘤相关的典型症状时。准确的骨髓分析对于确立最终诊断也至关重要。
