Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
Int J Lab Hematol. 2019 Feb;41(1):69-79. doi: 10.1111/ijlh.12924. Epub 2018 Sep 14.
Carcinocythemia is a rare phenomenon defined as morphologically identifiable, circulating tumor cells in the peripheral blood. No modern case series of carcinocythemia exists in the literature.
Blood smears from carcinocythemia patients were reviewed and associated clinicopathologic findings described and compared to the literature. When available, bone marrows were examined.
We identified 7 carcinocythemia cases over 3 years at our institution in 5 females and 2 males with a median age of 57 and compare them to 26 case reports in the literature (19 females, 10 males; median age 57). The primary neoplasms were carcinomas of breast (3 cases), lung, non-small cell (2 cases), prostate (1), and 1 case of unknown primary. Circulating tumor cells were associated with fragmentation hemolysis (2 cases), asplenic RBC changes (3 cases), and myeloid antigen expression by flow cytometry (2 cases) and were most commonly found at the feathered edge of the slide (6 cases) as single cells or in clusters.
This represents the largest series of carcinocythemia reported. The identification of 7 cases at one institution over a 3-year period suggests carcinocythemia may becoming more common. Raising awareness of this entity and its associated clinicopathologic findings may help avoid diagnostic pitfalls in blood smear examinations and may guide timely clinical management.
癌细血症是一种罕见的现象，其定义为外周血中形态上可识别的循环肿瘤细胞。目前文献中尚无癌细血症的现代病例系列。
对癌细血症患者的血涂片进行了回顾，并描述了相关的临床病理发现，并与文献进行了比较。当有骨髓检查时，也进行了检查。
我们在 3 年内于本机构共发现 7 例癌细血症患者，患者为 5 名女性和 2 名男性，中位年龄为 57 岁，并将其与文献中的 26 例病例报告（19 名女性，10 名男性；中位年龄 57 岁）进行了比较。主要的肿瘤为乳腺癌（3 例）、肺癌、非小细胞癌（2 例）、前列腺癌（1 例）和 1 例原发灶不明的癌。循环肿瘤细胞与碎片性溶血性贫血（2 例）、脾切除后 RBC 变化（3 例）和流式细胞术检测到髓样抗原表达（2 例）有关，并且最常出现在涂片的羽毛状边缘（6 例），为单个细胞或细胞簇。
这是报道的最大系列的癌细血症。在 3 年内于一家机构中发现 7 例病例表明癌细血症可能变得更为常见。提高对这种疾病及其相关临床病理发现的认识可能有助于避免血涂片检查中的诊断陷阱，并可能指导及时的临床管理。
