Korean J Hematol.  2009 Mar;44(1):58-61. 10.5045/kjh.2009.44.1.58.

Idiopathic Thrombocytopenic Purpura in a Patient with Carcinoma of the Uterine Cervix

• Kim HS
• Kim JH
• Na DK
• Zang DY
• Park MJ
• Kim HB
• Lee JW

• KMID: 2252176
• DOI: http://doi.org/10.5045/kjh.2009.44.1.58

Abstract

We describe here the case a patient with advanced cervix carcinoma and who developed idiopathic thrombocytopenic purpura (ITP). A 63-year-old woman with stage IV squamous cell carcinoma of the uterine cervix and that was complicated by hydronephrosis was treated palliatively with 45Gy of external beam radiation to the pelvis. About 3 years later, she developed hematochezia and severe thrombocytopenia. The laboratory examinations showed no evidence of thrombotic thrombocytopenic purpura or disseminated intravascular coagulopathy, and she was positive for serum anti-platelet antibodies. On the bone marrow examination, there was a normal number and morphology of megakaryocytes with no evidence of malignant cell infiltration. We made the clinical diagnosis of ITP, and the intravenous immunoglobulin and steroid therapy was successful. This case suggests the possibility that ITP can occur in association with advanced cervix carcinoma.

Keyword

Autoimmune thrombocytopena; Idiopathic thrombocytopenic purpura; Cervix carcinoma

MeSH Terms

Antibodies
Bone Marrow Examination
Carcinoma, Squamous Cell
Cervix Uteri
Female
Gastrointestinal Hemorrhage
Humans
Hydronephrosis
Immunoglobulins
Megakaryocytes
Middle Aged
Pelvis
Purpura, Thrombocytopenic, Idiopathic
Purpura, Thrombotic Thrombocytopenic
Thrombocytopenia
Antibodies
Immunoglobulins

Figure

• 

  Fig. 1. Peripheral blood smear shows severe thrombocytopenia with the presence of megaplatelets (arrow) and lack of schistocytes (Wright stain, 400×).

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  Fig. 2. Bone marrow examination reveals a slight hypocellular marrow with no evidence of neoplastic infiltration. Marrow megakaryocytes are normal in number and morphology. (Hematoxylin-Eosin, 400×).

Reference

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