Bone marrow fibrosis and metastatic prostate adenocarcinoma

A 52-year-old man presented to the outpatient department with breathlessness and generalised weakness since 2 months. He was found to have anaemia and thrombocytopenia. A complete haematological workup failed to point towards a definite aetiology. Bone marrow biopsy revealed fibrosis with predominantly collagen fibres. An elevated prostate-specific antigen level and CT scan of the abdomen and pelvis suggested prostate carcinoma, which prompted a transrectal ultrasound-guided biopsy, revealing a poorly differentiated adenocarcinoma of the prostate.