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Background & objective Introduction: First detection of any solid tumour as metastatic deposits in bone marrow directs clinicians to start searching for the primary tumour. Detection of bone marrow metastasis determines the stage of the malignancy, prognosis, mode of treatment, chemotherapeutic response and follow-up in case of relapse. The aim of the current study was to analyse the clinico-haematological presentation and morphological pattern of infiltration of solid tumours detected first as metastatic deposits on bone marrow examination. Methods Three-year retrospective analysis of MGG-stained bone marrow aspiration smears and touch imprints of the bone marrow biopsy and Hematoxylin and Eosin (H&E) stained histopathological sections of biopsies was performed at the Department of Pathology at a tertiary care institute (January 2014 to December 2016). The morphological pattern of metastatic deposits and haematological profiles of the patients were analysed. Exclusion criterion was the presence of hematolymphoid malignancies. Results In 22 cases, bone marrow was the first site of detection of metastasis. The age of the patients ranged from 3 years and 10 months to 82 years, with equal gender predilection. Overall, 16 cases had cytopenias, 9 cases each had leucocytosis and leukoerythroblastic presentation. The metastasis was from Ewing's sarcoma, prostate carcinoma, gastric adenocarcinoma invasive duct carcinoma breast, gallbladder carcinoma, lacrimal duct carcinoma and invasive papillary urothelial carcinoma. Conclusions Bone marrow examination is a cheap and reliable investigation to detect metastasis in an unsuspecting case. Bilateral trephine biopsies are recommended to increase the efficacy of detecting bone marrow metastasis.

The stomach is a very rare location of metastatic deposits. We present a case of a gastric metastatic deposit from primary colon cancer. Computed tomography (CT) indicated primary colon cancer, but also revealed presence of cancer in the region of the gastric greater curvature and gastric antrum. With the progression of primary cancer and the creation of an extraluminal tumor mass, the process progresses in the manner that the primary transversal colon tumor merges into the metastatic deposit located in the stomach. The patient underwent subtotal gastrectomy and D2 lymphadenectomy, as well as partial resection of the transversal colon, thus the tumor mass of the stomach and the one in the transversal colon being removed in a single act. Pathohistological analysis of the tumor mass and immunohistochemical tests revealed a primary neoplastic infiltrative process in the colon metastasing into the stomach., Желудникот е многу ретка метастатска локализација. Прикажуваме случај на метастатски депозит на желудник од карцином на колон. Kомпјутеризираната томографија (КT) укажуваше на примарен карцином на дебелото црево, но истовремено се детектира и карцином во предел на големата кривина и антрумот на желудникот. Со прогресија на примарниот карцином исоздавање на екстралуминална туморскамаса, процесот прогредира при што доаѓа до спојување на примарниот тумор на трансверзалниот дел на колонот со метастатскиот депозит во желудникот. Кај пациентот беше извршена субтотална гастректомија и Д2 лимфаденектомија, како и парцијална ресекција на колонот, при што, во еден акт е отстранета туморскатамаса на желудникот и трансверзалниот дел од колонот. Со патохистолошка анализа на туморот и со имунохистохемиски испитувања се утврди дека станува збор за примарен неоинфилтративен процес на колонот со метастаза на желудникот.

Желудникот е многу ретка метастатска локализација. Прикажуваме случај на метастатски депозит на желудник од карцином на колон. Kомпјутеризираната томографија (КT) укажуваше на примарен карцином на дебелото црево, но истовремено се детектира и карцином во предел на големата кривина и антрумот на желудникот. Со прогресија на примарниот карцином и создавање на екстралуминална туморска маса, процесот прогредира при што доаѓа до спојување на примарниот тумор на трансверзалниот дел на колонот со метастатскиот депозит во желудникот. Кај пациентот беше извршена субтотална гастректомија и Д2 лимфаденектомија, како и парцијална ресекција на колонот, при што, во еден акт е отстранета туморската маса на желудникот и трансверзалниот дел од колонот. Со патохистолошка анализа на туморот и со имунохистохемиски испитувања се утврди дека станува збор за примарен неоинфилтративен процес на колонот со метастаза на желудникот., The stomach is a very rare location of metastatic deposits. We present a case of a gastric metastatic deposit from primary colon cancer. Computed tomography (CT) indicated primary colon cancer, but also revealed presence of cancer in the region of the gastric greater curvature and gastric antrum. With the progression of primary cancer and the creation of an extraluminal tumor mass, the process progresses in the manner that the primary transversal colon tumor merges into the metastatic deposit located in the stomach. The patient underwent subtotal gastrectomy and D2 lymphadenectomy, as well as partial resection of the transversal colon, thus the tumor mass of the stomach and the one in the transversal colon being removed in a single act. Pathohistological analysis of the tumor mass and immunohistochemical tests revealed a primary neoplastic infiltrative process in the colon metastasing into the stomach.

Background Filariasis is a common cause of morbidity in certain parts of India, especially in the Coastal Districts. Repeated episodes of fever with chills and rigor, lymphadenopathy are the initial manifestations which gradually progress to elephantiasis. Wuchereria bancrofti is the most common parasite causing lymphatic filariasis in India. Detecting microfilaria in peripheral blood with or without Diethylcarbamazine citrate provocation is the common diagnostic modality in suspected cases. However microfilaria has been accidentally detected in fine needle aspirates, aspirated body fluids and even in bronchial washings. Case presentation We report a case of 65-year old female presented with back ache. On investigation she had leuco-erythroblastic blood picture in the peripheral smear and metastatic deposits in the bone marrow aspirate. W. bancrofti microfilariae was an incidental finding in the bone marrow aspirate. Conclusion Finding of microfilariae in the bone marrow aspirate in the absence of clinical features of lymphatic filariasis is extremely uncommon and mostly are incidental findings. The peripheral blood may or may not reveal the microfilariae and eosinophilia in the peripheral blood is absent in majority of the cases. All the bone marrow aspirates must be screened for microfilariae in the endemic areas to identify the asymptomatic carriers.