乳腺癌脾及骨髓等多处转移病例报道及文献复习

Case report of splenic and bone marrow metastasis from breast cancer and literature review

目的探讨乳腺癌脾及骨髓等多处转移的临床、影像学特征。方法回顾性分析武汉大学人民医院于2019年2月23日诊治1例乳腺癌脾及骨髓等多处转移患者的病例资料,分析其诊疗经过并复习相关文献。结果患者因左上腹疼痛入院,伴有贫血、血小板减少,CT提示脾大、脾占位性病变,骨扫描提示骨转移,骨髓穿刺检查提示乳腺癌骨髓转移,乳腺活检示乳腺癌,予以来曲唑治疗。2019年6月18日复查:左侧乳腺肿块,较前减小,脾脏体积增大,较前减轻,脾内低密度灶,范围较前减小。骨髓穿刺活检示骨髓增生极度减低。结论乳腺癌脾及骨髓转移非常罕见,影像学检查和骨髓穿刺检查是乳腺癌脾及骨髓转移的重要诊断方法,详细的病例资料、针对性的检查和全面的分析对于减少误诊具有重要意义。

Objective To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer. Methods Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23, 2019 were analyzed and literatures were reviewed. Results Patient admitted to hospital with pain in the left upper abdomen, accompanied with anemia and thrombocytopenia. CT suggested spleen occupying lesions. ECT implied bone metastasis. Bone marrow biopsy indicated breast cancer metastasis. Breast biopsy showed breast cancer. After using letrozole, the lesion of left breast and thevolume of spleen was reduced. The range of the spleen was lower than before. This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation. Conclusions Splenic and bone marrow metastasis from breast cancer are rare. Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases. Detailed case data, targeted examinations, and comprehensive analysis are important for reducing misdiagnosis.