BONE MARROW TOUCH 

BONE MARROW BIOPSY

A 58-year-old woman presented with costal pain for 2 months. CBC showed neutropenia and thrombocytopenia.

• Bone marrow aspiration and biopsy was done and revealed packed marrow. The findings revealed as figures. 

QUESTIONs:  

1.What are the abnormal findings in BM touch and biopsy? 

2.What is the most likely diagnosis?

โดย น.ท.สรพงษ์  มัณยานนท์ และ น.ท.หญิง อัชพร  วิจิตรานุช อาจารย์สาขาอายุรศาสตร์มะเร็งวิทยา กองอายุรกรรม รพ.ภูมิพลอดุลยเดช พอ.

ANSWERs

1.Abnormal findings in BM touch and biopsy

• The bone marrow touch smear demonstrates
  • Clusters of medium-to-large cells with high nuclear-to-cytoplasmic ratios, hyperchromatic nuclei, and irregular nuclear contours.
  • The chromatin appears coarse, and some nuclei are prominent.
  • The cytoplasm is scant to moderate and generally basophilic.
  • These cells are forming cohesive clusters, suggestive of an epithelial or carcinoma origin rather than hematopoietic cells.
• The bone marrow biopsy shows
  • Scanty hematopoietic precursors with crowded groups of oval neoplastic cells with large hyperchromatic nuclei, with modest granular cytoplasm

2.The most likely diagnosis 

• The findings are suggestive of metastatic carcinoma involving the bone marrow, given the epithelial-like clustering pattern, nuclear features, and lack of typical hematopoietic maturation.
• After undergoing complete investigations, the patient was diagnosed with primary breast cancer.

โดย น.ท.สรพงษ์  มัณยานนท์ และ น.ท.หญิง อัชพร  วิจิตรานุช อาจารย์สาขาอายุรศาสตร์มะเร็งวิทยา กองอายุรกรรม รพ.ภูมิพลอดุลยเดช พอ.