Metastatic disease

Here is a nice example of metastatic disease, specifically prostate cancer in the bone marrow

• You can appreciate the clumping of cells typical of non-haematopoeitic cells
• The bone marrow trephine also shows a very abnormal infiltrate
• The reason why the procedure was done because the serum PSA was low and pancytopenia
• Poorly differentiated prostate cancers with a high Gleason score often produce little PSA, and lower or even normal PSA values do not exclude bone metastases
• Prostate cancer cells invade the axial skeleton with an osteoblastic pattern, manifesting in osteosclerosis
• PSA and epithelial (AE1/AE, CAM5), lymphoma (CD20,CD3) and plasma cell (CD138) markers were negative

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