Metastatic signet ring gastric adenocarcinoma presenting with microangiopathic hemolytic anemia.
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.
Ali
Natasha
N
Department of Hematology, The Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan. natasha.ali@aku.edu
Kamran
Nausheen
N
Adil
Salman
S
Pervez
Shahid
S
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*