[A Case of Invasive Lobular Carcinoma Complicated by Disseminated Carcinomatosis of the Bone Marrow with Severe Bone Marrow Fibrosis and Acute Splenomegaly].

Q4 Medicine
Yumi Nozaki, Minori Yamamuro, Noriyoshi Tanaka, Nobuyuki Kamo, Mari Ueno, Tsuyoshi Ishida, Juichiro Konishi
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引用次数: 0

Abstract

A 60-year-old female presented at our hospital with a mass in her left breast. Needle biopsy of the breast mass confirmed a diagnosis of invasive lobular carcinoma, and the patient underwent left mastectomy and axillary lymph node dissection. The patient received adjuvant chemotherapy and was started on continuous endocrine therapy. Three years post-surgery, she experienced recurrence of multiple bone metastases and received a combination of hormone therapy and selective cyclin-dependent kinases 4/6 inhibitors. Therapeutic efficacy was poor, allowing bone metastases to spread. Four months post-recurrence, blood tests revealed moderate thrombocytopenia. Despite the switch to chemotherapy, the patient's platelet count did not recover. CT revealed splenomegaly, which was not present three months earlier. Bone marrow biopsy revealed severe myelofibrosis with infiltration of small dysplastic cells into dense fibrotic tissue. The patient developed microangiopathic hemolytic anemia, but DIC was not observed during the course of the disease. Ten months after recurrence, a brain metastasis was detected, and the patient died the following month.

浸润性小叶癌合并弥散性骨髓癌伴严重骨髓纤维化急性脾肿大1例。
一位60岁女性因左乳房肿块就诊于我院。乳腺肿块穿刺活检证实浸润性小叶癌,患者行左乳切除术和腋窝淋巴结清扫术。患者接受辅助化疗,并开始持续内分泌治疗。术后3年,患者出现多发性骨转移复发,接受激素治疗和选择性细胞周期蛋白依赖性激酶4/6抑制剂联合治疗。治疗效果差,使骨转移扩散。复发4个月后,血液检查显示中度血小板减少。尽管改用化疗,病人的血小板计数并没有恢复。CT显示脾肿大,3个月前未见。骨髓活检显示严重的骨髓纤维化,小的发育不良细胞浸润到致密的纤维化组织中。患者发展为微血管病性溶血性贫血,但在病程中未观察到DIC。复发10个月后,发现脑转移,患者于次月死亡。
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CiteScore
0.20
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337
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