Metastatic cells in bone marrow
Gerald Pittman, M.D.
Division of Laboratory Medicine
Kenneth S. K. Tung, M.B., B.S.
Department of Pathology
George C. Hoffman, M.B., B.Chir., M.R.C. Path.
Department of Laboratory Hematology
THE presence of metastatic cells in a bone marrow aspirate was reported by Rohr and Hegglin1 in 1936. The incidence of such a finding and the importance attached to it vary considerably in reports published since that time. Our report concerns a retrospective study of the case records of 83 patients whose bone marrows were found to contain metastatic cells. The purpose of the study was to determine the significance of bone marrow findings and to correlate the presence of metastatic cells with other laboratory findings.
Materials and methods
From 1959 through 1970 approximately 7,000 bone marrow aspirates were performed at the Cleveland Clinic. Of these, 83 contained metastatic cells, and are the basis of this study. In this group of patients, the indications for bone marrow aspirations varied widely, but it was not a part of the routine investigation of patients with cancer. Patients with myeloma, leukemia, or lymphoma were excluded from the study. The clinical record of each patient was reviewed, and the various investigations that led to the diagnosis of cancer were related temporally to one another. These investigations included the medical history, physical examination, roentgenographic findings, biopsy of the primary tumor, and bone marrow aspiration. The complete blood count, serum alkaline phosphatase content, and the duration of survival of each patient after bone marrow aspiration were observed when such information was available.
The bone marrow specimens were obtained from the sternum or from the posterior iliac crest. The aspirates were spread on coverslips and stained with . . .