Abstract
A 17-year-old girl was admitted to our hospital complaining of lumbago. Blood examination revealed anemia and thrombocytopenia. Bone marrow biopsy showed marked necrotic foci and groups of abnormal cells.
The patient responded well to the combination chemotherapy consisting of cyclophosphamide, vincristine and prednisolone initially, but died of progressive infiltration of CNS after about one year.
Autopsy revealed a gray-whitish, soft, friable, irregular nodular, partially necrotic and hemorrhagic tumor of about fist size in the postrior wall of urinary bladder. Specimens of the tumor revealed the histological picture of neuroblastoma characterized by rosette-formation. There were metastatic infiltrations in the right temporal region of meninges, both lungs, liver, lymphnode and bone (femur, vertebra and rib). Necrotic change and reticulin fibrosis were noted in her bone marrow.
Bone marrow necrosis is rarely found in bone marrow samples obtained during life. So far, ther has been no report that bone marrow necrosis was confirmed in a case of neuroblastoma by a bone marrow biopsy.
