Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates

ABSTRACT Introduction The causes of cytopenias are numerous, and the bone marrow aspirate helps to identify them. In rare cases, these cytopenias are due to bone marrow metastases from solid cancers. The techniques used in hematology laboratories are limited in characterizing these cells. Interactio...

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Main Authors: Elise Kaspi, Charlotte Grosdidier, Yaël Berda‐Haddad, Maud Arpin, Sylvie Cointe, Shirley Fritz, Amandine Bonifay, Marie Koubi, Carine Jiguet‐Jiglaire, Patrice Roll, Diane Frankel
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70645
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author Elise Kaspi
Charlotte Grosdidier
Yaël Berda‐Haddad
Maud Arpin
Sylvie Cointe
Shirley Fritz
Amandine Bonifay
Marie Koubi
Carine Jiguet‐Jiglaire
Patrice Roll
Diane Frankel
author_facet Elise Kaspi
Charlotte Grosdidier
Yaël Berda‐Haddad
Maud Arpin
Sylvie Cointe
Shirley Fritz
Amandine Bonifay
Marie Koubi
Carine Jiguet‐Jiglaire
Patrice Roll
Diane Frankel
author_sort Elise Kaspi
collection DOAJ
description ABSTRACT Introduction The causes of cytopenias are numerous, and the bone marrow aspirate helps to identify them. In rare cases, these cytopenias are due to bone marrow metastases from solid cancers. The techniques used in hematology laboratories are limited in characterizing these cells. Interaction with the cytopathology laboratory becomes critical for characterizing tumor cells and completing a comprehensive diagnosis from the bone marrow aspirate. Methods This article describes a series of 38 bone marrow aspirates from 36 patients with bicytopenias who underwent bone marrow aspiration and for whom the hematologists sent the sample to the cytopathology laboratory to complete the diagnosis by immunocytochemistry and FISH if necessary. Results The mean age of patients is 66 years, and the sex ratio is 2.8. Metastases were found in 11 cases of lung carcinoma, 4 cases of prostate carcinoma, 2 cases of breast carcinoma, 1 case of kidney carcinoma, 1 case of glioblastoma, 1 case of Ewing's sarcoma, and 1 case of melanoma. Among them, bone marrow aspiration was the only method to establish the initial diagnosis for seven patients. In six cases, immunocytochemistry confirmed the presence of carcinoma cells but could not identify their origin. In seven cases, tumor cells were insufficient to be characterized by immunocytochemistry. Conclusion Collaboration between laboratories is essential for the management of bone marrow aspirates containing non‐hematopoietic metastases. Bone marrow aspiration may be sufficient to diagnose solid tumors, enabling faster initiation of treatment for patients already at an advanced stage of their disease.
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spelling doaj-art-654474f9ea614bc9a3892bc8f153e1dc2025-08-20T02:22:09ZengWileyCancer Medicine2045-76342025-02-01143n/an/a10.1002/cam4.70645Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow AspiratesElise Kaspi0Charlotte Grosdidier1Yaël Berda‐Haddad2Maud Arpin3Sylvie Cointe4Shirley Fritz5Amandine Bonifay6Marie Koubi7Carine Jiguet‐Jiglaire8Patrice Roll9Diane Frankel10Cell Biology Department, APHM, INSERM, MMG, Timone Hospital Aix Marseille Universite Marseille FranceService of Medical Biology APHM, North Hospital Marseille FranceMedical Biological Laboratory—Hematology and Flow Cytometry Department Timone Hospital, APHM Marseille FranceMedical Biological Laboratory—Hematology and Flow Cytometry Department Timone Hospital, APHM Marseille FranceMedical Biological Laboratory—Hematology and Flow Cytometry Department Timone Hospital, APHM Marseille FranceMedical Biological Laboratory—Hematology and Flow Cytometry Department Timone Hospital, APHM Marseille FranceMedical Biological Laboratory—Hematology and Flow Cytometry Department Timone Hospital, APHM Marseille FranceDepartment of Internal Medicine CHU Nord, Assistance Publique‐Hôpitaux de Marseille (AP‐HM) Marseille FranceAPHM, CNRS, INP, Inst Neurophysiopathol, GlioME Team, Réseau PrEclinique et TRAnslationnel de Recherche en Neuro‐Oncologie, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie Aix‐Marseille Universite Marseille FranceCell Biology Department, APHM, INSERM, MMG, Timone Hospital Aix Marseille Universite Marseille FranceCell Biology Department, APHM, INSERM, MMG, Timone Hospital Aix Marseille Universite Marseille FranceABSTRACT Introduction The causes of cytopenias are numerous, and the bone marrow aspirate helps to identify them. In rare cases, these cytopenias are due to bone marrow metastases from solid cancers. The techniques used in hematology laboratories are limited in characterizing these cells. Interaction with the cytopathology laboratory becomes critical for characterizing tumor cells and completing a comprehensive diagnosis from the bone marrow aspirate. Methods This article describes a series of 38 bone marrow aspirates from 36 patients with bicytopenias who underwent bone marrow aspiration and for whom the hematologists sent the sample to the cytopathology laboratory to complete the diagnosis by immunocytochemistry and FISH if necessary. Results The mean age of patients is 66 years, and the sex ratio is 2.8. Metastases were found in 11 cases of lung carcinoma, 4 cases of prostate carcinoma, 2 cases of breast carcinoma, 1 case of kidney carcinoma, 1 case of glioblastoma, 1 case of Ewing's sarcoma, and 1 case of melanoma. Among them, bone marrow aspiration was the only method to establish the initial diagnosis for seven patients. In six cases, immunocytochemistry confirmed the presence of carcinoma cells but could not identify their origin. In seven cases, tumor cells were insufficient to be characterized by immunocytochemistry. Conclusion Collaboration between laboratories is essential for the management of bone marrow aspirates containing non‐hematopoietic metastases. Bone marrow aspiration may be sufficient to diagnose solid tumors, enabling faster initiation of treatment for patients already at an advanced stage of their disease.https://doi.org/10.1002/cam4.70645bone marrow aspiratebone marrow aspirationcarcinomaEwing sarcomamelanomametastasis
spellingShingle Elise Kaspi
Charlotte Grosdidier
Yaël Berda‐Haddad
Maud Arpin
Sylvie Cointe
Shirley Fritz
Amandine Bonifay
Marie Koubi
Carine Jiguet‐Jiglaire
Patrice Roll
Diane Frankel
Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
Cancer Medicine
bone marrow aspirate
bone marrow aspiration
carcinoma
Ewing sarcoma
melanoma
metastasis
title Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
title_full Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
title_fullStr Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
title_full_unstemmed Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
title_short Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non‐Hematopoietic Malignancies in Bone Marrow Aspirates
title_sort challenges and clinical relevance in diagnosing metastatic cells from non hematopoietic malignancies in bone marrow aspirates
topic bone marrow aspirate
bone marrow aspiration
carcinoma
Ewing sarcoma
melanoma
metastasis
url https://doi.org/10.1002/cam4.70645
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