内容紹介
Summary
This paper presents the case of an 84-year-old man who was referred to the clinic because of decreased appetite and weight loss. He was diagnosed with anemia and white blood cell count reduction by a local doctor. In consideration of blood diseases, he was referred to the hospital to the department of hematology, and laboratory tests revealed a white blood cell count of 4,400/μL, hemoglobin level of 8.0 g/dL, platelet count of 12,800/μL, and high PSA level of 12.895 ng/mL. Cancer cells were found in the bone marrow biopsy and tested negative on PSA immunostaining. PET-CT revealed increased accumulation of FDG in the whole bone marrow. A biopsy of the prostate showed poorly differentiated adenocarcinoma with a Gleason score of 5+5=10 and weakly positive PSA immunostaining. Prostate cancer with carcinomatosis of the bone marrow was diagnosed. He underwent bicalutamide and degarelix treatment. He was alive 12 months after his first visit.
要旨
症例は84歳,男性。食欲低下,体重減少があり,近医で貧血と白血球数減少を指摘され当院を受診した。血液疾患を考慮して血液内科に紹介し,血液検査で白血球数4,400/μL,Hb 8.0 g/dL,血小板12.8×10 4/μL,PSAは12.895 ng/mLと高値であった。骨髄生検で癌細胞がみられ,PSA免疫染色では陰性であった。PET-CTで全身骨髄にFDGの集積亢進を認めた。前立腺生検では低分化腺癌,Gleason score 5+5=10,PSA免疫染色では一部に弱陽性であった。骨髄癌腫症を伴う前立腺癌と診断し,ビカルタミドとデガレリクスを行った。現在,初診後12か月生存中である。
目次
This paper presents the case of an 84-year-old man who was referred to the clinic because of decreased appetite and weight loss. He was diagnosed with anemia and white blood cell count reduction by a local doctor. In consideration of blood diseases, he was referred to the hospital to the department of hematology, and laboratory tests revealed a white blood cell count of 4,400/μL, hemoglobin level of 8.0 g/dL, platelet count of 12,800/μL, and high PSA level of 12.895 ng/mL. Cancer cells were found in the bone marrow biopsy and tested negative on PSA immunostaining. PET-CT revealed increased accumulation of FDG in the whole bone marrow. A biopsy of the prostate showed poorly differentiated adenocarcinoma with a Gleason score of 5+5=10 and weakly positive PSA immunostaining. Prostate cancer with carcinomatosis of the bone marrow was diagnosed. He underwent bicalutamide and degarelix treatment. He was alive 12 months after his first visit.
要旨
症例は84歳,男性。食欲低下,体重減少があり,近医で貧血と白血球数減少を指摘され当院を受診した。血液疾患を考慮して血液内科に紹介し,血液検査で白血球数4,400/μL,Hb 8.0 g/dL,血小板12.8×10 4/μL,PSAは12.895 ng/mLと高値であった。骨髄生検で癌細胞がみられ,PSA免疫染色では陰性であった。PET-CTで全身骨髄にFDGの集積亢進を認めた。前立腺生検では低分化腺癌,Gleason score 5+5=10,PSA免疫染色では一部に弱陽性であった。骨髄癌腫症を伴う前立腺癌と診断し,ビカルタミドとデガレリクスを行った。現在,初診後12か月生存中である。