Case report: secondary thrombocytopenia and disseminated intravascular coagulopathy of the patient with generalized cancer of descending colon


Authors: J. Mertová 1;  D. Mikulenková 1;  P. Cetkovský 1;  R. Šimečková 1;  V. Campr 2
Authors‘ workplace: Ústav hematologie a krevní transfuze, Praha, 2Ústav patologie a molekulární biologie 2. LF UK a FN Motol 1
Published in: Transfuze Hematol. dnes,17, 2011, No. 2, p. 81-84.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

This case report summarizes history of the patient who complained about frequent back pain. These lead him to his general practitioner. The laboratory exams found severe thrombocytopenia and DIC (disseminated intravascular coagulopathy). The suspicion of acute leukaemia was not confirmed by bone marrow examination. However, infiltration by other non-haematological tumour was found. The search for primary malignancy was originated. Clinical suspicion of gastrointestinal tumour was not proven until patientęs death. Patient died of generalized cancer of descending colon with metastases to the liver and bones, complicated by secondary thrombocytopenia and disseminated intravascular coagulopathy. Diagnosis was made on autopsy.

Key words:
acute leukaemia, thrombocytopenia, disseminated intravascular coagulopathy, morphology, trephine biopsy


Sources

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2. Lee J-LY, Lee J-H, Kim M-K, et al. A case of bone marrow necrosis with thrombotic thrombocytopenic purpura as a manifestation of occult colon cancer. Jpn J Clin Onkol 2004; 34(8): 476-480.

3. Hubáček J, Faber E, Slezák P, et al. Mikroangiopatická hemolytická anémie jako první projev metastazujícího karcinomu. Prakt Lék 1996; 76(11): 555-558.

4. Hussain S, Chui S. Gastric carcinoma presenting with extensive bone metastases and marrow infiltration causing extradural spinal haemorrhage. Brit J Radiol 2006; 79(939): 261-263.

5. Ozkalemkas F, Ali R, Ozkocaman V, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases. BMC Cancer 2005; 5:144

6. Wong KF, Chan JKC, Ma SK. Solid tumour with initial presentation in the bone marrow – a clinicopathologic study of 25 adult cases. Hematol Oncol 1993; 11(1): 35-42.

7. Tocar M, Bobilev D, Ariad S, Geffen DB. Disseminated intravascular coagulation at presentation of advanced gastric cancer. Israel Med Assoc J 2006; 8: 853-855.

Labels
Haematology Internal medicine Clinical oncology
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