CASE HISTORY

In January 1935, patient had her right breast removed for a carcinoma which had been present for four years. She recovered from the operation but subsequently suffered from increasing weakness. On admission, 1.1.36. she was found to be extremely pale with a slight lemon tint. Although still fairly well covered she had lost considerable weight. The mastectomy wound showed a secondary deposit in the form of a small ulcerated area over the fifth rib. The spleen was palpably enlarged. A blood count on admission showed - RBC 1,500,00; Hb 22%; WBC 5,400, differential count - polynuclears 74%, lymphocytes myelocytes 2%; reticulocytes 5.4%. 6.1.36. Blood transfusion given. 10.1.36. General condition improved, blood count unchanged. X-ray examination showed multiple, ragged, opaque areas throughout the lumber spine and sacrum, and also an enlarged and relatively opaque spleen. Patient's general condition steadily deteriorated and she died 6.2.36. Diagnosis: Leuco-erythroblastic anaemia secondary to carcinoma of breast with bone metastasis.

PATHOLOGY

Except for a small area at the lower end, there is practically no marrow remaining. It has been replaced by a sclerotic overgrowth through which are scattered numerous, prominent, opaque areas of tumour.