Breast Cancer Metastasis to Bone Marrow: Cytology

A clinical case of breast adenocarcinoma metastasis to bone marrow: cytological features, osteoblasts, osteoclasts, and biochemical markers.

Editorial team 1 min June 21, 2023

Bone marrow smear: complex of non-hematological adenocarcinoma cells

Bone marrow smear: scattered atypical non-hematopoietic cells

Bone marrow smear: a pair of atypical cells suspicious for carcinoma

Bone marrow smear: cluster of solid cancer tumor cells

Bone marrow smear: fibrocytes and osteoblast in metastatic process

Bone marrow smear: large multinucleated osteoclast in aspirate

Bone marrow smear: osteoclast of characteristic branched shape

Bone marrow smear: osteoblast with eccentrically located nucleus

Bone marrow smear: cluster of mature osteoblasts in the preparation

Printout of biochemical blood test with elevated ALP to 385 U/L and LDH

⚠ Bone marrow metastasis. 👉Clinical case kindly provided by a doctor from Israel🇮🇱. ✅Patient: 41-year-old woman complaining of weakness and fatigue. Peripheral blood showed anemia, hemoglobin 81 g/L, hypochromic macrocytic, thrombocytopenia 30 thousand/µL, changes in biochemical parameters (photo below). ✅Bone marrow trepanobiopsy and aspiration were performed for microscopy and IPT (immunophenotyping). ✅Aspiration was difficult, and scanty material was obtained. IPT showed no abnormalities. ✅In bone marrow smears, against the background of scarce cellularity, we see osteoblasts, osteoclasts, and fibrocytes. Also, a small number of scattered cells and small clusters of non-hematological origin were found. Presumably carcinoma cells. ✅Histological examination confirmed breast adenocarcinoma and bone marrow metastasis.