Bone Marrow Involvement in Non-Hematological Malignancy: A Clinico-pathological Study From a Tertiary Hospital

Abstract

Background- Bone marrow is an important site for metastasis in cases of non hematological malignancies and is routinely performed to stage the disease or to rule out metastasis in suspected cases.. Purpose- Purpose of the study is to evaluate bone marrow in cases of solid tumors and also to enumerate the types of tumors metastasizing to marrow at our institute. Methods- This was a retrospective study and clinical and laboratory data were retrieved from case files and laboratory records. All the case where bone marrow aspirate was performed to rule out metastasis or for staging were included along with those cases where patient presented to us with hematological abnormalities and diagnosed to have a metastasis in marrow. Results- Out of total 758 cases of total bone marrow performed, 89 were performed in proven cases of non hematological malignancies of which 31 showed tumor deposits. While in two cases metastatic deposits were first seen in marrow aspirate. Most common tumor metastasizing to marrow at our institute was adenocarcinoma of lung followed by breast and small cell carcinoma of lung. In pediatric age group most common tumor was Ewing’s sarcoma followed by rhabdomyosarcoma. Most common peripheral smear abnormality seen was thrombocytopenia followed by anemia and leukoerythroblastic blood picture. Conclusion- Bone marrow aspiration is an easy, rapid and sensitive technique to determine metastasis of solid tumors in bone marrow and can be performed in hematological abnormalities to rule out any metastasis in otherwise unsuspected cases.