BONE MARROW INVOLVEMENT IN NON HAEMATOLOGICAL MALIGNANCIES: A CLINICO - PATHOLOGICAL STUDY FROM A TERTIARY CARE CENTER OF KASMIR VALLEY

Introduction: Solid tumors may spread to the Bone Marrow via the hematogenous route. Most common solid tumors which metastasize to marrow in adults are carcinoma of the prostate, breast and lung. In pediatric age group neuroblastoma, rhabdomyosarcoma, Ewing?s sarcoma and retinoblastoma are the major tumors metastasizing to BM. The clinical features of these may mimic some of the haematologic disorders, as the patients may present with cytopenias, lymphadenopathy and Hepatosplenomegaly Aim of this study was to analyse the bone marrow involvement in non haematological malignancies. Material and methods: This was a retrospective study conducted in the department of haematology ,Sher e Kashmir Institute of Medical Sciences for a period of 5 years from January 2012 to December 2016. In this retrospective study, bone marrow aspiration showing metastases of solid tumors were studied. Basic clinical characteristics of patients and complete blood counts were obtained from the hospital records. Cases having bone marrow infiltration by lymphoma were excluded from the study. Results: In a period of 5 years,68 bone marrow aspirations showing metastatic deposits were studied. 40 patients were Males(58.8%) and 20 were females(29.4%) .Age of the cases ranged from 8 months to 80 years with mean age of 49.2 years. 20 cases(29.5%) were in paediatric age group. Anemia was seen at presentation in 38 cases(55.8%) while thrombocytopenia was seen in 35 cases(51.4%). Lung cancer and neuroblastoma were the most frequent malignancy metastasising to marrow in adults and paediatric population respectively. Conclusion: Bone marrow aspiration is an effective method for evaluating solid tumors metastatic to bone marrow. Aspiration of bone marrow provides an easy and quick way of detection of marrow involvement, however, biopsy with immunohistochemical and / or molecular techniques may be needed in case of microscopical tumor metastasis.