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骨髓癌转移导致胃腺癌患者发生血栓性微血管病和弥散性血管内凝血:病例报告。

Thrombotic microangiopathy and disseminated intravascular coagulation in a patient with carcinomatosis of the bone marrow due to gastric adenocarcinoma: Case report.

机构信息

1Associate Professor. Department of Internal Medicine. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia. Intensive Care Unit, Hospital Universitario San Ignacio. Bogotá, Colombia.

2Assistant Professor. Department of Internal Medicine. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia. Nephrology Unit, Hospital Universitario San Ignacio. Bogotá, Colombia.

出版信息

Rom J Intern Med. 2023 Jun 30;61(3):167-174. doi: 10.2478/rjim-2023-0015. Print 2023 Sep 1.

Abstract

Carcinomatosis of the bone marrow is a rare clinical condition characterized by diffuse tumor infiltration of the bone marrow accompanied by hematological abnormalities, including thrombotic microangiopathy (TMA) and disseminated intravascular coagulation (DIC). In patients with gastric carcinoma, this association is infrequent. Below we present a case of a 19-year-old female patient with no known pathological history who presented with upper digestive tract bleeding. Upon examination, anemia and thrombocytopenia were documented, with schistocytes in the peripheral blood smear and prolonged coagulation times. Endoscopic studies indicated a lesion in the Borrmann IV gastric body, and the bone marrow biopsy showed the presence of signet ring cells. Because there was no possibility of systemic therapy, the patient died during hospitalization. This case contributes to the medical literature by describing an unusual presentation of a very frequent pathology.

摘要

骨髓转移癌是一种罕见的临床病症,其特征为骨髓弥漫性肿瘤浸润,伴有血液学异常,包括血栓性微血管病(TMA)和弥散性血管内凝血(DIC)。在胃癌患者中,这种关联并不常见。下面我们介绍一例 19 岁女性患者,无已知病史,表现为上消化道出血。检查发现贫血和血小板减少,外周血涂片有裂片红细胞,凝血时间延长。内镜研究提示胃体 Borrmann IV 型病变,骨髓活检显示存在印戒细胞。由于没有全身治疗的可能,患者在住院期间死亡。本病例通过描述一种非常常见的病理表现的不寻常表现,为医学文献做出了贡献。

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