Abstract
A case of myelophthitic anemia was reported. The predisposing factor was carcinoma of the stomach with widespread metastases, especially to the bone marrow.
The clinical manifestations of this patient were thrombocytopenia and disorders on blood coagulation system.
A 52-year-old female was admitted to the G-U Department of the Atami National Hospital on Nov. 6, 1966, with gross hematuria, lower abdominal pain and low back pain of 5 days duration.
Complete urological work up revealed right renal bleedingwithout any abnormal findings on pyelogram.
Laboratory examination showed moderate anemia (Hb: 8.0g/dl, R. B. C.: 249×104) and thrombocytopenia (6.4×\104) with erythroblasts and immature white cells in the peripheral blood smear. Low blood fibrinogen content with high fibrinolytic activity was also noted. Bone marrow study demonstrated large atypical cells in 14 per cent.
The patient was expired on the 11th day of hospitalization being suffered from coma after progressive conscious disturbance, despite complete disappearance of her chief complaints on the 7th day of admission.
Autopsy findings were as follows; carcinoma of the stomach originating in lesser curvature with metastases to (1) lymph-nodes, (2) pancreas, lungs, liver and dura mata with intracanalicular cancer cell thrombosis, and (3) bone marrow with intensive invasion of cancer cells. Intracranial bleeding which was induced by metastasis to the dura mats and hemorrhagic tendency, was the cause of her death.
Atypical out-standings of this case were discussed in detail.
