PROGNOSTIC INFORMATION FROM CHEMOTHERAPY-ASSOCIATED CHANGES IN BONE MARROW METASTASIS OF NEUROBLASTOMA- A CASE REPORT
Journal Title: IJAR-Indian Journal of Applied Research - Year 2019, Vol 9, Issue 6
Abstract
Neuroblastoma is the most common extra-cranial solid tumour in children. Bone marrow examination is a part of diagnosis and staging workup of neuroblastoma. Chemotherapy forms mainstay of treatment and post-chemotherapy histological changes are an important indicator of prognosis. A 4-year-old male child came with complaints of fever and hepatomegaly. Investigations revealed a retroperitoneal neuroblastoma. Bone marrow was involved by neuroblasts (stage 4S). Platinum-based chemotherapy was started and post-induction phase bone marrow showed differentiation of neuroblasts to ganglion cells and schwannian stroma (tumour load <5%, minimal disease). The patient was lost to follow up thereafter. The patient returned after one year with the reappearance of neuroblasts (tumour load >20%, relapse) in the bone marrow. Use of immunohistochemical markers like chromogranin and S100 are helpful to map the tumour load and identify the tumour cells when they are sparse. Persistence / reappearance of neuroblasts post-chemotherapy or increasing tumour load indicate a relapse.
Authors and Affiliations
Varun Kumar Singh, Anjali Vijay, Sushma Belurkar, Shiny Amber
Keywords
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