title: Metastatic signet ring gastric adenocarcinoma presenting with microangiopathic hemolytic anemia.
abstract: Metastatic adenocarcinoma presenting as microangiopathic hemolytic anemia (MAHA) and leukoerythroblastic blood picture is rare. We report three patients who presented with MAHA as the initial symptom of metastatic signet ring cell gastric adenocarcinoma. One patient had past history of gastric ulcer. In all these patients the initial diagnosis was based on peripheral blood smear followed by bone marrow biopsy; upper GI endoscopy showed presence of gastric ulcers with focally scattered neo-plastic signet ring cells on histopathology. All patients died within a week of diagnosis.
authors.affiliation: Department of Hematology, The Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan. natasha.ali@aku.edu
authors.forename: Natasha
authors.initials: N
authors.lastname: Ali
authors.forename: Nausheen
authors.initials: N
authors.lastname: Kamran
authors.forename: Salman
authors.initials: S
authors.lastname: Adil
authors.forename: Shahid
authors.initials: S
authors.lastname: Pervez
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000209:etiology*; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000556:secondary*; D018279:Carcinoma, Signet Ring Cell / Q000556:secondary*; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology*