Clinical observation of small cell neuroendocrine cancer of the tracheal bifurcation zone, with metastasis to the bone marrow, liver, spleen

Aim. Demonstration of a clinical case of a patient with small cell neuroendocrine cancer of the tracheal bifurcation zone, with metastases to the bone marrow, liver, spleen.

Materials and methods. A brief review of the literature on the diagnosis of neuroendocrine tumors of the lungs and bronchi is presented, and a clinical observation of small cell neuroendocrine cancer of the tracheal bifurcation zone with metastases to the bone marrow, liver and spleen from the personal practice of the authors is presented.

Results. The clinical picture of this patient was dominated by “hematological” manifestations: severe thrombocytopenia and hemorrhagic syndrome, anemia, due to which differential diagnosis with a systemic blood disease was initially carried out. There was no pain syndrome in the bones characteristic of metastatic lesions. Histological examination of the bronchial tumor biopsy and bone marrow trephine biopsy with immunohistochemical examination (IHC) helped in making the diagnosis. In both cases, IHC revealed tumor cells with the same phenotype.

Conclusion. Metastasis of tumors to the bone marrow can proceed without characteristic ossalgia and manifest itself only in hematological syndromes (changes in blood tests). Cytological and histological examination of the bone marrow, with IHC, helps in the diagnosis.

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