Myelophthisic Anemia in a Patient with Lobular Breast Carcinoma Metastasized to the Bone Marrow

Abstract

Breast tumors have a predilection for metastasizing to the bone leading to cells being displaced by the cancer cells subsequently producing immature leukocytes and erythrocytes in the peripheral blood. We present a case of a 57-year-old female who was found to have myelophthisic anemia secondary to stage four lobular breast carcinoma metastasized to the bone marrow after being misdiagnosed as having thrombotic thrombocytopenia purpura. Diagnosis of myelophthisic anemia requires a thorough workup and treatment is based upon secondary management of the malignancy.

Keywords: a disintegrin and metalloproteinase with a thrombospondin type 1 motif (member 13); adamst13; er; estrogen receptor; her2; human epidermal growth factor receptor 2; pr; progesterone receptor; thrombotic thrombocytopenic purpura; ttp.

Figure 1. Fragmented red blood cells (schistocytes), as shown by the arrow.

Figure 2. A) White arrows point to mixed lytic and sclerotic lesions of the calvarium found on computed tomography (CT) scan of the head without contrast. B) White arrows point to osteoblastic lesions of the pelvis found on CT scan of the abdominopelvic region without contrast. C) Yellow marker shows 1.2 cm ovoid soft tissue nodular opacity at the 6 o’clock position of the right breast.

Figure 3. Atypical tumor cells, as shown by the arrow.