BONE MARROW ASPIRATION IN THE DIAGNOSIS OF METASTASIS OF PROSTATIC CARCINOMA

Abstract

The diagnosis of bone metastasis of the prostatic carcinoma is usually based on the findings of the roentgenogram of the pelvis, lumbosacral spine and other skeleton parts. The bone metastasis, however, is not always demonstrated radiologically as abnormal findings. Schackmann reported macroscopically visible, but radiologically invisible, metastases in more than half of the cases examined at autopsy.
Rundle et al. and some other investigators found that examination of bone marrow from patients with the prostatic carcinoma could be helpful in the diagnosis of bone metastasis.
We had performed the bone marrow aspiration in 18 cases of the prostatic carcinoma, and the following results were obtained.
1) Of the hormonally untreated 10 cases, 4 cases showed positive bone marrow findings (bone marrow bearing tumor cells) with abnormally high levels of serum acid phosphatase and 2 cases of them revealed radiologically normal findings. Four cases were demonstrated as metastatic findings in roentgenogram, but 2 cases of them had negative bone marrow findings and normal levels of serum acid phosphatase.
2) All of the hormonally treated cases revealed negative bone marrow findings regardless of the positive radiological findings and high serum acid phosphatase levels in some cases.
3) It was considered that normal radiological findings could not always make a denial of bone metastases, as well as the osteoplastic roentgenograms would not necessarily indicate active metasta tic lesions.
4) The procedures of bone marrow aspiration were simple and easy, and none of the complications were observed.
5) Regarding to the diagnostic and prognostic significances of this examination, the bone marrow aspiration would be recommended as a routine work for the prostatic malignancy.