Bicytopenia and leukoerythroblastosis: a rare initial presentation of signet ring cell gastric adenocarcinoma

Authors

  • Vilma Takayasu University of São Paulo, Hospital Universitário, Internal Medicine Division
  • Edna Harumi Goto University of São Paulo, Hospital Universitário, Internal Medicine Division
  • Mayra Zanon Casagrande University of São Paulo, Faculty of Medicine, Internal Medicine Department
  • Paulo Guilherme de Arruda Miranda University of São Paulo, Faculty of Medicine, Internal Medicine Department
  • Gabriela Bezerra de Freitas Diniz Instituto de Infectologia Emilio Ribas
  • Micaela Frasson Monteiro Instituto de Infectologia Emilio Ribas
  • Aloisio Felipe-Silva University of São Paulo, Hospital Universitário, Anatomic Pathology Service University of São Paulo, Faculty of Medicine, Department of Pathology

DOI:

https://doi.org/10.4322/acr.2017.014

Keywords:

Stomach Neoplasms, Carcinoma, Signet Ring Cell, Bone Marrow, Neoplasm Metastasis

Abstract

Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss. The physical examination revealed pallor, and the laboratory work-up depicted severe anemia and thrombocytopenia; the peripheral blood smear was consistent with leukoerythroblastosis. The ongoing investigation through a bone marrow biopsy showed massive involvement of the bone marrow by a signet ring cell adenocarcinoma. During hospitalization, the patient presented melena, and an upper digestive endoscopy depicted an ulcerated and infiltrative lesion in the cardia, upon which the histological examination revealed a signet ring cell adenocarcinoma. This case highlights the bone marrow invasion represented by bicytopenia and leukoerythroblastosis as the initial manifestation of this histological type of gastric cancer. Although treatment attempts were made with chemotherapy and radiotherapy, the patient died early on, showing the aggressive behavior of this form of tumoral presentation

Downloads

Download data is not yet available.

Downloads

Published

2017-06-30

How to Cite

Takayasu, V., Goto, E. H., Casagrande, M. Z., Miranda, P. G. de A., Diniz, G. B. de F., Monteiro, M. F., & Felipe-Silva, A. (2017). Bicytopenia and leukoerythroblastosis: a rare initial presentation of signet ring cell gastric adenocarcinoma. Autopsy and Case Reports, 7(2), 55-60. https://doi.org/10.4322/acr.2017.014

Issue

Section

Article / Clinical Case Report