Detection of Bone Marrow Involvement in Patients with Cancer

1989 ◽  
Vol 75 (2) ◽  
pp. 90-96 ◽  
Author(s):  
Massimo Federico ◽  
Richard L. Magin ◽  
Harold M. Swartz ◽  
Robert M. Wright ◽  
Vittorio Silingardi
Keyword(s):  
Computed Tomography ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Bone Marrow Involvement ◽  
High Sensitivity ◽  
Hematologic Malignancies ◽  
Skeletal Metastases ◽  
Patients With Cancer ◽  
Magnetic Resonance Imaging Mri

Current methods for the study of bone marrow to evaluate possible primary or metastatic cancers are reviewed. Bone marrow biopsy, radionuclide scan, computed tomography and magnetic resonance imaging (MRI) are analyzed with regard to their clinical usefulness at the time of diagnosis and during the course of the disease. Bone marrow biopsy is still the examination of choice not only in hematologic malignancies but also for tumors that metastasize into the marrow. Radionuclide scans are indicated for screening for skeletal metastases, except for those from thyroid carcinoma and multiple myeloma. Computed tomography is useful for cortical bone evaluation. MRI shows a high sensitivity in finding occult sites of disease in the marrow but its use has been restricted by high cost and limited availability. However, the future of MRI in bone marrow evaluation seems assured. MRI is already the method of choice for diagnosis of multiple myeloma, when radiography is negative, and for quantitative evaluation of lymphoma when a crucial therapeutic decision (i.e. bone marrow transplantation) must be made. Finally, methods are being developed that will enhance the sensitivity and specificity of MRI studies of bone marrow.

scholarly journals Whole-Body Functional MRI and PET/MRI in Multiple Myeloma

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3155
Author(s):  
Sébastien Mulé ◽  
Edouard Reizine ◽  
Paul Blanc-Durand ◽  
Laurence Baranes ◽  
Pierre Zerbib ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Functional Mri ◽  
Bone Marrow Involvement ◽  
High Sensitivity ◽  
Response To Treatment ◽  
Whole Body ◽  
Response Evaluation ◽  
Whole Body Mri ◽  
Dce Mri

Bone disease is one of the major features of multiple myeloma (MM), and imaging has a pivotal role in both diagnosis and follow-up. Whole-body magnetic resonance imaging (MRI) is recognized as the gold standard for the detection of bone marrow involvement, owing to its high sensitivity. The use of functional MRI sequences further improved the performances of whole-body MRI in the setting of MM. Whole-body diffusion-weighted (DW) MRI is the most attractive functional technique and its systematic implementation in general clinical practice is now recommended by the International Myeloma Working Group. Whole-body dynamic contrast-enhanced (DCE) MRI might provide further information on lesions vascularity and help evaluate response to treatment. Whole Body PET/MRI is an emerging hybrid imaging technique that offers the opportunity to combine information on morphology, fat content of bone marrow, bone marrow cellularity and vascularization, and metabolic activity. Whole-body PET/MRI allows a one-stop-shop examination, including the most sensitive technique for detecting bone marrow involvement, and the most recognized technique for treatment response evaluation. This review aims at providing an overview on the value of whole-body MRI, including DW and DCE MRI, and combined whole-body 18F-FDG PET/MRI in diagnosis, staging, and response evaluation in patients with MM.

scholarly journals The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms

2022 ◽  
Vol 6 ◽  
Author(s):  
Kiflom S. Gebreslassie ◽  
Fatima C. Bassa ◽  
Zivanai C. Chapanduka ◽  
James M. Warwick
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Pet Ct ◽  
Plasma Cell Neoplasms ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
The Relationship

Synchronous presentation of Gaucher disease and solitary plasmacytoma with progression to multiple myeloma

2011 ◽  
Vol 56 (4) ◽  
pp. 1-4 ◽  
Author(s):  
M P H Hawkesford ◽  
A J Bowey ◽  
J Rao ◽  
N J Meara
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Gaucher Disease ◽  
Weight Bearing ◽  
Lytic Lesion ◽  
Solitary Plasmacytoma ◽  
Lytic Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

A 37-year-old Polish immigrant presented with unilateral hip pain and difficulty weight-bearing. Plain radiography and magnetic resonance imaging (MRI) revealed a lytic lesion in the acetabulum, with abnormal serum electrophoresis and bone marrow biopsy. The patient was diagnosed with two rare conditions presenting synchronously – Gaucher disease and plasmacytoma. He was treated with enzyme therapy and radiotherapy, but subsequently developed a recurrence of plasmacytoma in the right femur, confirmed with bone marrow biopsy. This was also treated with radiotherapy, followed by a retrograde femoral nail to reduce the risk of pathological fracture. The patient went on to develop multiple lytic lesions in the ribs and vertebra, seen on MRI. Further bone marrow biopsy confirmed dissemination of the plasmacytoma into multiple myeloma, for which he was treated with systemic chemotherapy. In patients presenting with refractory bone or joint pain, haematological and histological investigations should be considered to exclude less common diagnoses.

scholarly journals Bone marrow abnormalities detected by magnetic resonance imaging as initial sign of hematologic malignancies

2018 ◽  
Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Cell Types ◽  
Hematologic Malignancies ◽  
Resonance Imaging ◽  
Initial Sign ◽  
Magnetic Resonance Imaging Mri

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.

The Certainty of a Post-Bone Marrow Diagnosis: A Study of the Yield of Bone Marrow Biopsies in a Community Hospital Setting

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 34-35
Author(s):  
Manasi M. Godbole ◽  
Peter A. Kouides
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Fever Of Unknown Origin ◽  
Conflicts Of Interest ◽  
Diagnostic Yield ◽  
Hospital Setting ◽  
Unknown Origin ◽  
Nutritional Deficiencies ◽  
Bone Marrow Biopsies

Introduction: Most studies on the diagnostic yield of bone marrow biopsy including the one by Hot et al. have focused on the yield of bone marrow biopsies in diagnosing the source of fever of unknown origin. However, there have not been any studies performed to our knowledge looking at overall practice patterns and yield of bone marrow biopsies for diagnoses other than fever of unknown origin. We aim to determine the most common indications for performing bone marrow biopsies in a community-based teaching hospital as well as the yield of the biopsies in patients with specified and unspecified pre-test indications to estimate the rate of uncertain post-test diagnoses. Methods: We performed a retrospective data collection study at Rochester General Hospital, NY. A comprehensive search was conducted in our electronic medical data to identify all patients who underwent bone marrow biopsies over a 5 year period from January 2011 - December 2016 for indications other than fever of unknown origin. Patient data including demographics, pre-bone marrow biopsy diagnosis and post-bone marrow diagnosis was obtained. All patients above the age of 18 who underwent bone marrow biopsy for indications other than fever of unknown origin or follow up treatment of a hematological malignancy were included. Results: A total of 223 biopsies were performed. The median age was 59 years (age range- 23-95). One hundred and sixteen patients were male and 107 were female. The most common indications for performing bone marrow biopsy were evaluation of the following possible conditions: multiple myeloma (n=54), myelodysplastic syndrome [MDS] (n=47), lymphoma (n=28) and leukemia (n=18) as well as non-specific indications such as pancytopenia (n=40), anemia (n=22) and thrombocytopenia (n=11). The proportion of cases confirmed by bone marrow biopsy was 45/54 (83%) with the pre-marrow diagnosis of multiple myeloma, 34/47 cases (72%) with the pre-marrow diagnosis of MDS, 15/18 (83%) with the pre-marrow diagnosis of leukemia and 13/28 (46%) in those with the pre-marrow diagnosis of rule out lymphoma. Thirteen cases (18%) with possible MDS had post-bone marrow diagnoses of leukemia, anemia of chronic disease, myelofibrosis or medication-related changes. Five out of twenty two cases (23%) for anemia and 3/11 cases (27%) for thrombocytopenia without otherwise specified pre-bone marrow etiology had uncertain diagnosis after bone marrow biopsy. Conclusion: In about a fifth of patients necessitating a bone marrow, the diagnosis is discordant and can be surprising. It is also worth reporting that in these discordant results, non-hematological causes such as medications, anemia due to chronic diseases or conditions such as cirrhosis or splenomegaly from other etiologies were among the final diagnoses. Interestingly, 20% of the patients with unspecified pre-bone marrow diagnoses such as anemia or thrombocytopenia in our study had an unclear post-bone marrow diagnosis despite undergoing bone marrow biopsy. Our findings are a reminder that the bone marrow exam does not always lead to a definitive diagnosis and the need by exclusion to include in the differential non-hematological etiologies such as nutritional deficiencies, chronic kidney disease or autoimmune disorders. Disclosures No relevant conflicts of interest to declare.

scholarly journals Soluble stem cell factor receptor (CD117) and IL-2 receptor alpha chain (CD25) levels in the plasma of patients with mastocytosis: relationships to disease severity and bone marrow pathology

Blood ◽  
2000 ◽  
Vol 96 (4) ◽  
pp. 1267-1273 ◽  
Author(s):  
Cem Akin ◽  
Lawrence B. Schwartz ◽  
Takashi Kitoh ◽  
Hirokazu Obayashi ◽  
Alexandra S. Worobec ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Mast Cell ◽  
Disease Severity ◽  
Bone Marrow Biopsy ◽  
Systemic Mastocytosis ◽  
Bone Marrow Involvement ◽  
Surrogate Markers ◽  
Receptor Alpha ◽  
Alpha Chain ◽  
Receptor Alpha Chain

Abstract Systemic mastocytosis is a disease of mast cell proliferation that may be associated with hematologic disorders. There are no features on examination that allow the diagnosis of systemic disease, and mast cell–derived mediators, which may be elevated in urine or blood, may also be elevated in individuals with severe allergic disorders. Thus, the diagnosis usually depends on results of bone marrow biopsy. To facilitate evaluation, surrogate markers of the extent and severity of the disease are needed. Because of the association of mastocytosis with hematologic disease, plasma levels were measured for soluble KIT (sKIT) and soluble interleukin-2 receptor alpha chain (sCD25), which are known to be cleaved in part from the mast cell surface and are elevated in some hematologic malignancies. Results revealed that levels of both soluble receptors are increased in systemic mastocytosis. Median plasma sKIT concentrations as expressed by AU/mL (1 AU = 1.4 ng/mL) were as follows: controls, 176 (n = 60); urticaria pigmentosa without systemic involvement, 194 (n = 8); systemic indolent mastocytosis, 511 (n = 30); systemic mastocytosis with an associated hematologic disorder, 1320 (n = 7); aggressive mastocytosis, 3390 (n = 3). Plasma sCD25 levels were elevated in systemic mastocytosis; the highest levels were associated with extensive bone marrow involvement. Levels of sKIT correlated with total tryptase levels, sCD25 levels, and bone marrow pathology. These results demonstrate that sKIT and sCD25 are useful surrogate markers of disease severity in patients with mastocytosis and should aid in diagnosis, in the selection of those needing a bone marrow biopsy, and in the documentation of disease progression.

The significance of bone marrow involvement in non-Hodgkin's lymphoma: the Eastern Cooperative Oncology Group experience.

1986 ◽  
Vol 4 (10) ◽  
pp. 1462-1469 ◽  
Author(s):  
J M Bennett ◽  
K C Cain ◽  
J H Glick ◽  
G J Johnson ◽  
E Ezdinli ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Hodgkin’S Lymphoma ◽  
Bone Marrow Involvement ◽  
Eastern Cooperative Oncology Group ◽  
Stage Iv ◽  
Hodgkin's Lymphoma ◽  
Stage Iii ◽  
Oncology Group ◽  
Non Hodgkin's Lymphoma

Data from four clinical trials conducted by the Eastern Cooperative Oncology Group (ECOG) were used to investigate the importance of bone marrow involvement as a prognostic factor in patients with non-Hodgkin's lymphoma (NHL). A total of 502 patients, 275 with nodular, poorly differentiated lymphocytic lymphoma (NLPD) and 227 with diffuse histiocytic lymphoma (DHL) or diffuse mixed-cell lymphoma (DML), were included in this analysis. Patients were separated into four categories: stage III, stage IV with bone marrow involvement (stage IV-M), stage IV without marrow involvement (stage IV-O), and stage IV with bone marrow and other organ involvement (stage IV-OM). Among the DHL and DML patients, the incidence of marrow involvement was 23%. However, stage IV-M patients had a prognosis that is similar to stage IV-O and stage IV-OM and worse than stage III patients. In contrast, the incidence of involvement with NLPD was 59% and patients with stage IV-M had a survival not different than stage III and not worse than stage IV-O and stage IV-OM. The results suggest that the current emphasis on bone marrow biopsy(s) as a routine diagnostic staging procedure for patients with NHL should be reevaluated. The necessity for this procedure in stage III patients with NLPD is not apparent from our data. One can still justify a bone marrow biopsy in stage I and II patients and can confirm the complete clinical response when all nodes have regressed in more advanced disease.

scholarly journals The Importance of Bone Marrow Biopsy in the Staging of Patients With Lymphosarcoma

Blood ◽  
1973 ◽  
Vol 41 (6) ◽  
pp. 913-920 ◽  
Author(s):  
Vincent Vinciguerra ◽  
Richard T. Silver
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Clinical Stage ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Valuable Procedure ◽  
Physical Findings ◽  
Positive Results ◽  
Extent Of Disease ◽  
Initial Staging

Abstract The frequency of bone marrow involvement in patients with lymphosarcoma (LSA) and the particular value of the marrow biopsy, as compared with the aspiration smear technique, in the initial staging of this disease were investigated. Certain physical findings and laboratory studies were analyzed to determine whether the presence of marrow invasion could be predicted. Of 75 patients, 47 (63%) were found to have a positive marrow examination. The clinical stage of 40 of these 75 patients was changed to stage IV as a result of bone marrow biopsy; these included four of nine (44%) stage I patients, 9 of 12 (75%) stage 5 patients, and 27 of 41 (65%) stage III patients. Bone marrow biopsy more often yielded positive results (62%) than did aspiration smears (38%). Little correlation was found between extent of disease on initial physical examination and marrow involvement. A normal hematocrit, white blood cell count, and/or platelet count did not preclude the presence of marrow invasion. The technique of bone marrow biopsy is a simple and valuable procedure in the staging of lymphosarcoma. It uncovers unsuspected and widespread diseases in those patients whose illness appears restricted to even one or two node groups. The high frequency of marrow involvement in patients with LSA is evidence that many patients have widespread disease at the time of diagnosis; thus, marrow biopsy, when positive, is an invaluable test for their initial staging. We urge that it be performed routinely in all patients, irrespective of apparent clinical extent of disease.

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