Many malignant tumors can potentially metastasize to the bone marrow. However, this occurs most frequently in carcinomas of the breast, lung, kidney, thyroid and prostate glands. Most bone metastases are osteolytic. Affected areas radiographically show less bone density. Osteoblastic metastases typically occur with carcinomas of the prostate or breast.
Bone metastases can lead locally to pain. Pathological fractures (absence of adequate trauma) occur in osteolytic metastases.
In advanced metastases of bone marrow, bone marrow insufficiency with pancytopenia. Typically, a leukoerythroblastic blood picture occurs with myelocytic precursor cells, normoblasts as well as poikilocytosis with tear drop cells. The occurrence of a microangiopathic picture is observed especially in bone marrow metastases of stomach carcinomas.
Bone marrow metastases typically manifest themselves in films as epithelial growths. It is easier to recognize them in lower magnification. The metastatic cells are often larger as hematopoietic cell and differ from these cytologically.