Case Study 16

ANSWER

1. D

Discussion:
Bone marrow tissue sections are superior to bone marrow smears for the detection of metastatic tumors. Metastatic tumors tend to clump together and are frequently associated with bone marrow fibrosis, as in this case. Cytochemical and immunohistochemical techniques are useful in distinguishing metastatic neoplasms from bone marrow malignancies and in subclassifying the metastatic tumors. Common tumors that metastasize to bone include: lung , gastrointestinal, breast, prostate, renal, pancreas and thyroid carcinoma. Of these, pancreatic carcinoma is known for its poor prognosis. Tumors arising in the body or tail can present clinically as a solitary bone metastasis.

References
Dorfman, H.D. and Czerniak B. Metastatic Tumors in Bone in Bone Tumors. Mosby, St. Louis 1998, 19:1009

Anner RM, Drewinko B: Frequency and significance of bone marrow involvement by metastatic solid tumors. Cancer 39:1337, 1977

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