home
about the project
Medical news
For authors
Licensed books on medicine
<< Previous Next >>

Anemia in malignant tumors and their multiple metastases in the bone marrow

The cause of the anemic condition in malignant tumors can be the following factors: 1) the toxic effect of the malignant tumor on erythropoiesis; 2) bleeding due to decay of the tumor and rupture of blood vessels; 3) secondary joining infection; 4) an erythropoiesis disorder due to bone marrow metastases; 5) achilia (with cancer of the stomach) and the associated violation of the assimilation of antianemic substances and iron; 6) liver damage (with metastases or with primary liver cancer).

Particular consideration is required for anemia in cancerous bone marrow metastases.

Most often, cancer of the prostate, breast, stomach, lungs, thyroid gland, kidneys (hypernephroma) metastases in the bone. When a malignant tumor is metastasized to the bone marrow, anemic syndrome occupies a major place in the clinical picture of the disease. The initial focus of the process - the tumor that caused the dissemination of cancer through the bones, is often so small that it remains as if in the shade and is not determined by any research methods. Distinctive features of this anemia are an unusually pronounced erythro- (normo) blastosis and a leukemoid blood picture. However, in 1/3 of cases, even with the enormous spread of bone metastases, a leukemoid reaction may be absent.

Not always with cancerous metastases in the bone marrow, the blood picture is so characteristic. We observed extensive cancer metastases in the bone marrow with minor changes in peripheral blood. There is no doubt that the blood picture for cancer metastases in the bone marrow depends not only on the invasive factor - implantation of cancer cells in the bone marrow, but also on the reactivity of the bone marrow. There is no connection between the type of tumor and the nature of the reaction of the bone marrow.

The following types of reactions of the hematopoietic system to cancerous metastases in the bone marrow are distinguished (Dustin).

1. Myeloid reaction (myeloma), characterized by the presence in the blood of young cells of the granulo-and erythropoietic series. Myelia can be observed without severe anemia.

2. Erythroblastic reaction, usually with pronounced anemia. However, in some cases, there is a disproportion between high erythroblastosis and a slight degree of anemia.

3. A leukemoid reaction characterized by high leukocytosis, sometimes with a large number of myelocytes.

4. Pan-hemocytopenic reaction, manifested in a decrease in the number of all blood elements - red blood cells, white blood cells and blood platelets. Similar blood carotene imitates the blood picture in panmyelopathies (aplastic anemia, panmyelophthis).

5. Anemic reaction without the appearance in the peripheral blood of young (immature) elements.

According to our observations, two more must be added to these forms: 1) hemorrhagic and 2) hemolytic.

The pathogenesis of each of these forms is complex.

The hemorrhagic form of bone marrow carcinosis is primarily associated with thrombocytopenia and associated with the latter hemogenic syndrome (impaired retraction of a blood clot, prolonged duration of bleeding). G.A. Dashtayants leads 7 cases of carcinosis to the bone marrow, which imitated Werlhof's symptom complex. In the case described by us (1953), in a patient with diffuse bone marrow carcinosis due to metastases of gallbladder cancer, hemorrhagic syndrome proceeded according to the hemophilic type, with reduced blood coagulation.

The hemolytic form of bone marrow carcinosis proceeds as acquired hemolytic anemia and jaundice with predominantly intracellular hemolysis, but without a pronounced enlargement of the spleen.
In the case we observed, a decreased resistance of red blood cells with spherocytosis was observed with a negative Coombs reaction. The literature describes cases that occurred as Markiathav syndrome - with intravascular hemolysis, hemoglobinuria and hemosiderinuria, but with a positive Coombs reaction.

Osteolytic and osteoplastic forms of bone marrow carcinosis are distinguished by the nature of the reaction of the surrounding bone tissue to cancer metastases.

Sometimes there is a significant difficulty or inability to puncture the sternum in case of cancerous osteosclerosis. Sometimes punctate is obtained without an impurity of blood, which makes it difficult to make smears (you have to resort to crushing the resulting piece of tissue between two glasses). The search for cancer cells should be carried out at low magnification; found groups of cells are identified under the immersion system. Most often, osteoplastic forms of carcinosis are found in metastases of gastric cancer.

The cytological diagnosis of cancer cells in sternal punctate is not particularly difficult. The most important sign of cancer cells is their atypia in relation to the surrounding myeloid tissue. In general, cancerous metastasis to the bone marrow is recognized not only on the basis of the study of individual cells (because the morphology of cancer cells is very diverse and depends on the type of neoplasm), but also on the basis of findings of cell clusters or cords consisting of atypical, i.e., non-bone marrow tissue . Along with atypical cells uncharacteristic of bone marrow, whose membership in metastases is not in doubt, neoplastic cells are found in bone marrow punctate, which undergo some kind of metaplasia in the bone marrow, acquiring some properties of myeloid elements, in particular, azurophilic granularity. In some cases, a single cancer cell may resemble either a giant reticular cell (such as a Sternberg cell) or macroscopic hemocytoblast.

With diffuse bone marrow metaplasia with foreign tissue, the blood picture may approach that observed in acute myelogenous leukemia. This was the case with the patient we observed, in which lung cancer was accompanied by diffuse metastasis to all bones: in the blood there were many undifferentiated cells such as micromyeloblasts, and bone marrow puncture was made up of elements of small cell cancer. In general, the differential diagnosis of bone marrow carcinosis with systemic lesions, especially in the presence of a leukemoid blood picture, presents significant difficulties. The diagnosis becomes even more difficult in cases of hemorrhagic or hemolytic syndrome, as well as in the presence of an enlarged spleen. The latter is observed with carcinosis or due to metastases in the spleen (which is relatively rare), or due to the development of vicarious blood formation in it, especially with osteoplastic carcinomas. In these cases, the similarity of the disease with systemic lesions of blood formation becomes even more pronounced.
<< Previous Next >>
= Skip to textbook content =

Anemia in malignant tumors and their multiple metastases in the bone marrow

  1. TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATED MESENCHIMES
    TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATIVES
  2. DIRECT RESULTS OF COMBINED TREATMENT OF MULTIPLE METASTASES IN LIGHT CERVICAL CANCER
    Florovskaya N.Yu. 1, Kurpeshev O.K. 2, Davydenkova N.A. 1. Kononova G.V.3 1 Murmansk Regional Oncology Center; 2 Russian Medical Radiological Center at the Russian Academy of Medical Sciences, Obninsk; 3Medical Department of GlaxoSmithKline Trading, Moscow Actuality of the problem: Metastases to the lungs with cervical cancer (cervical cancer) develop in 16-20% of patients and become
  3. Bleeding from injuries and malignant genital tumors
    ETIOLOGY AND PATHOGENESIS Bleeding due to traumatic injuries of the genital tract can occur during defloration (especially in children and adolescents), during intercourse (maybe in women giving birth), during rape, in accidents, injuries, during the introduction of foreign bodies into the vagina with The goal of masturbation or abortion, during a criminal abortion. Bleeding with
  4. Surgery of the superior vena cava and its inflows in malignant tumors of the chest
    Bogdanovich A.S., Tarasov V.A. Department of Thoracic Surgery GOU DPO SPb MAPO Research objectives: To establish the effectiveness of surgical treatment in patients with common forms of malignant tumors of the chest organs complicated by the superior vena cava syndrome Material and methods: In the clinic of thoracic surgery SPbMAPO based on the surgical thoracic department of the City
  5. ADDISON-BIRMER'S DISEASE (MALIGNANT Anemia, PERNICIOUS ANEMIA, B12-DEFICIENCY ANEMIA)
    The disease described by Addison in 1855 and Biermer in 1868 gained fame among doctors as pernicious anemia, i.e., the disease is fatal, malignant. Only in 1926, in connection with the discovery of hepatic therapy of pernicious anemia, the prevailing idea over the course of a century about the absolute incurability of this disease was refuted. Clinic. Usually sick people over 40 years old.
  6. Bone marrow and hematopoiesis
    Characterization of bone marrow hematopoiesis In a human embryo, the bone marrow is laid by the end of the 3rd month. There are two groups of cells in the bone marrow: cells of the reticular stroma, which make up a minority, and cells of the hematopoietic tissue (parenchyma) of the bone marrow with their derivatives - mature blood cells. The cells of the reticular stroma include fibroblasts, osteoblasts, fat cells,
  7. USE OF PERFUSION TECHNIQUES IN THE PREVIOUS FORMS OF MALIGNANT TUMORS OF THE BREAST AND ABDOMIN
    Tarasov V.A., Khubulava G.G., Larin I.A., Litvinov A.Yu., Bogdanovich A.S., Zhuravlev V.P., Naumov A.B., Povarenkov A.S., Biryukov A.V., Romanovsky D.Yu., Butuzov A.G. Department of Thoracic Surgery; GOU DPO St. Petersburg Medical Academy of Postgraduate Education of the Federal Agency for Healthcare and Social Development of Roszdrav; First Department of Surgery named after P.A. Kupriyanov;
  8. The prevalence of primary multiple malignant neoplasms in the territory of the Altai Territory
    Sekerzhinskaya E.L., Terekhova S.A., Petrova V.D., Shoikhet Y.N., Lazarev A.F. Altai branch of the Russian National Medical Center named after N.N. Blokhin RAMS; GUZ Altai Regional Oncology Center, Barnaul Relevance: Relevance is due to an increase in the number of patients with primary multiple malignant neoplasms (PMZN) on the one hand and the lack of updated data on the prevalence of PMZN on
  9. Malignant tumors
    SARCOM is a malignant tumor from the mesenchymal tissue. Unlike sarcoma cancer, the first metastases are hematogenous. Histogenesis sarcomas are divided into a number of varieties. From fibrous tissue. 1. Fibrosarcoma. 2. Swelling dermatofibroma (malignant histiocytoma) - unlike other sarcomas, it is characterized by slow growth and does not give metastasis for a long time, although it grows
  10. EXPERIENCE OF APPLICATION OF IRESA DRUG AS QUALITY 1 LINE OF MEDICINAL TREATMENT IN AGE AND WEAKNESS PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH METASTASES IN THE BRAIN
    Strygina E.A., Kazantseva M.V., Davidenko I.S. Clinical Oncology Center DZ of the Krasnodar Territory Study objective: To evaluate the effectiveness and tolerability of Iressa treatment in weakened and aged patients with non-small cell lung cancer (NRL) with metastatic brain damage in the 1st line of drug treatment. Material and Methods: Summary of Treatment Results
  11. The participation of hematopoietic bone marrow cells in the process of metastasis: new targets for the diagnosis and destruction of cancer cell metastases
    The reasons why cancer cells can leave the primary focus of cancer and migrate to other parts of the body are not fully understood. Many lives can be saved if it is possible to stop this process. Until now, it was believed that the site of metastasis is determined by what organ or organs with the flow of blood the cancer cell or cells from the primary focus of cancer get into. From it due to division
  12. Malignant Intestinal Tumors
    - these are pathological proliferation of atypical cells with an autonomous (not always) progressive irreversible nature of growth, which replace and infiltrate normal tissue. Classification of the Stage of cancer Stage 1 - a tumor of small size, localized in the thickness of the mucosa or submucosal layer, without metastases; Stage 2: a) a large tumor, but not more than a semicircle
  13. Tumors from plasma cells - multiple myeloma and plasma cell dysrasia.
    These tumors constitute a group of diseases in which monoclonal proliferation of malignant plasma cells occurs. This can lead to the appearance of multiple foci of tumor growth in the bone marrow (multiple myeloma), a single and often extramedullary tumor node (plasmacytoma), or diffuse infiltration of the bone marrow, lymph nodes, spleen and liver
  14. Anemia in dystrophic conditions
    Anemia with dystrophic
Medical portal "MedguideBook" © 2014-2019
info@medicine-guidebook.com