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Metastatic Neuroblastoma

View larger version (122K): [in this window] [in a new window]   Figure 1. Bone marrow aspirate from an 11 year old child who was being evaluated for an abdominal mass is shown. A large clump of adherent, intermediate-sized mononuclear cells is evident in the center of the smear in addition to the normal hematopoietic elements seen onthe remainder of the slide. (Wright-Giemsa 10x)

View larger version (166K): [in this window] [in a new window]   Figure 2. Several clumps of non-hematopoietic cells with syncytium formation are evident in this view. Individual cell cytoplasmic borders can not be defined. (W-G 10x)

View larger version (132K): [in this window] [in a new window]   Figure 3. Syncytium formation by the tumor is more apparent at higher magnificaion with individual nuclei identifiable but cytoplasmic borders of individual cells being indistinct. (W-G 40x)

View larger version (107K): [in this window] [in a new window]   Figure 4. The tumor cells are forming small gland-like structures (Homer-Wright rosettes - arrows) without a central clear space. These structures are typically found in neuroblastomas but can also be found in other malignancies. (W-G 40x)

View larger version (145K): [in this window] [in a new window]   Figure 5. Large groups of pale appearing non-hematopoietic cells displacing the hematopoietic elements are seen in several areas of he biopsy. Normal myeloid precursors are present on the left edge of the marrow space. An interstitial pattern of tumor infiltration can also be seen at the lower border of the specimen. (H&E 4x)

View larger version (156K): [in this window] [in a new window]   Figure 6. The nodular and interstitial pattern of infiltration is more apparent at higher magnification. The tumor cells have indistinct cytoplasmic borders, nuclei with irregular borders and contain one or more nucleoli. A mitotic figure and apoptotic cells are seen within the tumor mass. Numerous eosinophils surround the neuroblastoma infiltrate. (H&E 10x)

View larger version (133K): [in this window] [in a new window]   Figure 7. A higher magnification of the infiltrate from another section of the marrow biopsy is shown. (H&E 40x)

View larger version (151K): [in this window] [in a new window]   Figure 8. An immunohistochemical stain for chromogranin shows a diffuse area of tumor infiltrate with additional small groups of positive-staining cells noted in areas of otherwise normal hematopoiesis. (H&E 4x)

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Articles by Turyan, H. Search for Related Content PubMed Articles by Lazarchick, J. Articles by Turyan, H. Related Collections Bone marrow manifestations of inflammatory or other systemic (non-infectious disease) Related ASH-SAP Chapter Related Image Bank Image Sets Social Bookmarking                   What's this?