Tumor metastases in bone marrow.

By ULFAR JONSSON, M.D.,* AND R. W. RUNDLES, M.D. T HE NOTORIOUS tendency of some tumors to metastasize by way of the i)lOOd stream and lodge in the hone marrow has been discussed in a previous communication dealing with carcinomas arising from the prostate glandl.1#{176} Individuals who have fever, pain, weight loss, etc., d!ue to widespread neoplastic disease before there are local signs or symptoms of tumor growth usually present difficult diagnostic problems. Infiltration of the hone marrow with tumor tissue may lead to blood abnormalities such as progressive anemia, sometimes with immature granulocytes and nucleated red cells in the circulating blood, thrombocytopenic purpura,’#{176} etc. Skeletal disease, another common result of 1)loodborne metastases, may resemble primary bone tumor, multiple myeloma, hyperparathyroidism,’7 lipoid granuloma, or Paget ‘s disease.4 The possibility of recognizing tumor cells in bone marrow aspirated from the sternum was first studied! in 1936 by Rohr and Hegglin)4 They found tumor cells in 11 of 75 patients with neoplastic disease. Many investigators were subsequently able to identify tumor implants in aspirated hone marrow.2 ‘