Simultaneous Presentation of Hairy Cell Leukemia and Metastatic Signet Ring Carcinoma of the Stomach Diagnosed by Bone Marrow Biopsy

Peruničić-Jovanović, Maja; Đjunić, Irena; Tomin, Dragica; Terzić, Tatjana; Jaković, Ljubomir; Sokic, Aleksandra; Gotić, Mirjana

doi:10.1097/pai.0b013e3181f7b30f

Cited by 4 publications

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“…The relative risk of second cancers reported in various series of HCL patients ranged from 0.95 to 4.33, but simultaneous presentation of HCL and solid malignancies is very rare. Simultaneous presentation of HCL and solid malignancy is exceptional and only a few cases have been described [12][13][14] . It has been described synchronous occurrence of HCL with neuroendocrine colon carcinoma, HIV-negative Kaposi's sarcoma and signet ring carcinoma of the stomach [12][13][14] .…”

Section: Discussionmentioning

confidence: 97%

Specificity of treatment is mandatory in very old patients with hairy cell leukemia

2015

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Section: Discussionmentioning

confidence: 97%

Specificity of treatment is mandatory in very old patients with hairy cell leukemia

2015

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“…19 Subsequently, other studies in HCL patients reported ranges of relative risk of second carcinogenesis of 0.95–4.33. 20 In 1997, a study conducted at the M.D. Anderson Cancer Registry involving 350 patients with HCL described 26 cases (7.4%) of second cancers.…”

Section: Discussionmentioning

confidence: 99%

Synchronous gastric and ampullary adenocarcinomas in a hairy cell leukemia patient treated with pentostatin eight years prior

Senatore

Dasanu

2015

J Oncol Pharm Pract

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Hairy cell leukemia patients are at increased risk for second malignancies, including both solid and lymphoid neoplasms. Along with other factors, multiple immune defects present in hairy cell leukemia likely contribute to subsequent carcinogenesis. We report herein a case of synchronous high-grade gastric and ampullary adenocarcinomas in a patient with a history of hairy cell leukemia treated eight years prior with pentostatin. We include a review of immune alterations induced by both hairy cell leukemia and its therapies, and link them with the occurrence of second cancers in these patients.

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“…[1–24] However, it should be noted that hematolymphoid neoplasms can also present with signet-ring cell morphology which may lead to diagnostic pitfalls. [24–28] Here, we present a very unusual case of a 67-year-old female with invasive lobular breast carcinoma, confirmed by breast biopsy and histopathologic examination. One year after surgery with combined chemotherapy and radiotherapy, the patient was noted to be thrombocytopenic.…”

Section: Introductionmentioning

confidence: 95%

Signet-ring cells in the bone marrow as an indication of cryptic metastasis of breast carcinoma

Leckey

Zhang

et al. 2019

Medicine

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Rationale:Signet-ring cell is a rare morphological finding in bone marrow, which usually indicates metastatic carcinoma from either the gastrointestinal tract or a primary hematolymphoid neoplasm. Here, we present a very unusual case of lobular breast carcinoma with metastasis to the bone marrow.Patient concerns:A 67-year-old female with estrogen receptor (ER)-positive lobular breast carcinoma was staged as T3N3M0, and treated with modified radical mastectomy followed by chemotherapy and radiotherapy. One year after treatment, she was noted to have moderate thrombocytopenia on complete blood count with the remainder of the parameters within normal limits. Radiographic examination revealed no evidence of recurrent disease.Diagnosis:Bone marrow biopsy was performed to exclude therapy-related myelodysplastic syndrome (MDS), which demonstrated hypercellularity with “hyperplastic” hematopoiesis. Upon closer inspection, a few signet-ring cells were identified which morphologically resembled histiocytes. These formed an interstitial infiltrate among the predominantly hematopoietic elements, and could have been easily overlooked. Immunohistochemistry demonstrated that these signet-ring cells were positive for pancytokeratin as well as ER which confirmed metastatic lobular breast carcinoma. On retrospective review of the aspirate smear, rare signet-ring cells were identified.Interventions:The patient was treated with additional chemotherapy.Outcomes:The patient eventually succumbed to overt dissemination after 14 months.Lessons:Due to the relative discohesiveness of lobular breast carcinoma, the cells frequently assume single-cell infiltration in bone marrow. This attribute, along with small cell size, bland cytologic features and paucity of tissue response, contributes to its escaping from identification on hematoxylin-eosin (H&E) sections. In this case, the signet-ring cells were hidden in apparently hyperplastic hematopoiesis. Careful inspection raised the possibility of occult metastasis which was readily detected and confirmed with immunohistochemistry.

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Simultaneous Presentation of Hairy Cell Leukemia and Metastatic Signet Ring Carcinoma of the Stomach Diagnosed by Bone Marrow Biopsy

Cited by 4 publications

References 0 publications

Specificity of treatment is mandatory in very old patients with hairy cell leukemia

Specificity of treatment is mandatory in very old patients with hairy cell leukemia

Synchronous gastric and ampullary adenocarcinomas in a hairy cell leukemia patient treated with pentostatin eight years prior

Signet-ring cells in the bone marrow as an indication of cryptic metastasis of breast carcinoma

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