Myerowitz R L, Edwards P A, Sartiano G P
Cancer. 1977 Dec;40(6):3107-11. doi: 10.1002/1097-0142(197712)40:6<3107::aid-cncr2820400653>3.0.co;2-5.
A patient with a 17-year course of metastatic lobular carcinoma of the breast is described who developed large numbers of circulating carcinoma cells which were easily detectable in several routine peripheral blood smears shortly before death. This rare complication of carcinoma has been called "carcinocythemia." Carcinocythemia is probably due to widespread infiltration of many bone marrow sites and may also be related to splenectomy, which may impair reticuloendothelial clearance of circulating tumor cells. The differential diagnosis of carcinocythemia from superimposed acute myelogenous leukemia, which can complicate radiotherapy and chemotherapy for the primary tumor, is discussed. Cytomorphology, histochemistry, and electron microscopy of abnormal circulating cells should aid in the distinction of these two processes.
本文描述了一位患有转移性乳腺小叶癌17年的患者，该患者在死亡前不久，外周血涂片中有大量循环癌细胞，这些癌细胞在数张常规外周血涂片上很容易被检测到。这种罕见的癌症并发症被称为“癌细胞血症”。癌细胞血症可能是由于多个骨髓部位广泛浸润所致，也可能与脾切除术有关，脾切除术可能会损害循环肿瘤细胞的网状内皮清除功能。本文还讨论了癌细胞血症与急性髓系白血病的鉴别诊断，急性髓系白血病可能会使原发性肿瘤的放疗和化疗复杂化。异常循环细胞的细胞形态学、组织化学和电子显微镜检查有助于区分这两种情况。
