Blood Res 2018; 53(1): 9  https://doi.org/10.5045/br.2018.53.1.9
Renal cell carcinoma metastasizing to the myeloproliferative bone marrow
Thein Hlaing Oo1*, and Roberto Nicolas Miranda2

1Section of Benign Hematology, The University of Texas M.D. Anderson Cancer Center, Houston, USA.

2Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, USA.

Correspondence to: Thein Hlaing Oo, M.D., Section of Benign Hematology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1464, Houston, TX 77030, USA. theinoomd@gmail.com, thoo@mdanderson.org
Received: May 6, 2017; Accepted: July 2, 2017; Published online: March 31, 2018.
© The Korean Journal of Hematology. All rights reserved.

 

figure

A 58-year-old man was diagnosed with essential thrombocythemia in 2010 and was managed with hydroxyurea and aspirin. In October 2014, he presented with right pleural effusion. Work-up revealed renal cell carcinoma metastasizing to the right pleura and lung parenchyma. Complete blood count (CBC) revealed white blood cells (WBC) 8.6×109/L, hemoglobin 11.4 g/dL and platelets 294×103/µL. He underwent pleural decortication and right middle lobectomy, followed by left radical nephrectomy. In January 2015, sunitinib was started (after discontinuing hydroxyurea) resulting in initial tumor response. In May 2015, the cancer progressed and experimental trial was considered. At that point, CBC showed hemoglobin 9.6 g/dL, WBC 7.9×109/L, platelets 446×103/µL. Bone marrow aspirate shows clusters of malignant cells (A, ×100). Bone marrow core biopsy revealed metastases (B, blue arrow, ×40) and residual myeloproliferative marrow (B, green arrow). Malignant cells with clear cytoplasm, large nuclei with prominent nucleoli and vacuoles are seen (C, ×400). PAX-8 staining was positive in carcinoma cells (D, ×400). Residual hypercellular marrow with dysplastic megakaryocytes with clustering in the residual marrow (E, ×400) is observed. This bone marrow biopsy thus reveals two simultaneously coexisting neoplastic conditions.



e-submission

This Article

Current Issue

ba_link01

Indexed/Covered by

Today : 126  /
Total : 113,424