Leland J, MacPherson B
Am J Clin Pathol. 1979 Jan;71(1):31-5. doi: 10.1093/ajcp/71.1.31.
The hematologic findings in 22 cases of mammary cancer metastatic to bone marrow are presented. Cancer of the breast was the most frequent neoplasm metastatic in bone marrow in this study of 2,878 bone-marrow examinations. All 22 patients who had carcinoma of the breast metastatic to bone marrow had clinical, radiographic, or hematologic evidence of widespread metastatic disease. Peripheral blood was abnormal in 58% of the cases, and in most of these cases two or more abnormalities were present. Bone-marrow biopsies were superior to particle sections and aspirates in identifying tumor, but correlations among all modalities were necessary for proper interpretation. Although the morphologic features of tumor cells in sections and smears were quite characteristic for carcinoma of the breast, pitfalls in interpretation were numerous and should be recognized. The mean survival time of these patients was only 6.9 months after identification of bone-marrow metastases. The significant response to chemotherapy obtained with some individuals, however, should encourage aggressive therapy of this disorder.
本文报告了22例乳腺癌骨髓转移的血液学检查结果。在这项对2878例骨髓检查的研究中,乳腺癌是骨髓中最常见的转移瘤。所有22例发生乳腺癌骨髓转移的患者均有广泛转移疾病的临床、影像学或血液学证据。58%的病例外周血异常,且大多数病例存在两种或更多异常。骨髓活检在识别肿瘤方面优于切片和抽吸物,但所有检查方法之间的相互关联对于正确解读是必要的。尽管切片和涂片上肿瘤细胞的形态特征对乳腺癌具有相当的特异性,但解读中仍存在许多陷阱,应予以认识。这些患者在确诊骨髓转移后的平均生存时间仅为6.9个月。然而,部分患者对化疗有显著反应,这应鼓励对该疾病进行积极治疗。