Bone Marrow Necrosis Associated With Tumor Emboli and Disseminated Intravascular Coagulation

Francisco-Javier Laso, MD; Marcos González-Díaz, MD; José-Ignacio Paz, MD; Sisinio De Castro, MD
Arch Intern Med. 1983;143(11):2220. doi:10.1001/archinte.1983.00350110214057.
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To the Editor.  —Bone marrow necrosis, which has been described in sickle cell disease, infectious diseases, and cancer,1-6 is a disorder rarely diagnosed during life. In the November 1982 Archives (1982;142:2223-2225), Pardoll et al reported a case of bone marrow necrosis associated with sickle cell disease. Reticuloendothelial scans showed widespread abnormalities consistent with marrow infarction; widespread microvascular obstruction by masses of sickle cells seems plausible as a mechanism of marrow necrosis.5 Nevertheless, the bone marrow necrosis pathogenesis is unknown in neoplasia and infectious diseases. We report a case of bone marrow necrosis diagnosed antemortem in a patient with gastric metastatic adenocarcinoma, where postmortem pathologic studies may bring further knowledge about necrosis physiopathology.

Report of a Case.  —A 60-year-old man was admitted to the hospital after three weeks of fever, dyspnea, and bone pain in the lower part of the back. Physical examination showed a severely ill patient, pale with petechia on the limbs, and necrosis in his right toes.


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