title: Circulating Breast Carcinoma Cells Mimicking Therapy-Related Acute Myeloid Leukemia.
abstract: Circulating tumor cells are rare in peripheral blood smears. We report the case of a patient with circulating breast carcinoma cells resembling circulating myeloid blasts and provide a brief review of the literature. Peripheral blood smears and a bone marrow aspirate were examined morphologically and by flow cytometry and fluorescence in situ hybridization (FISH). Bone marrow histology in conjunction with immunohistochemical stains was also evaluated. A population of atypical cells with blast-like morphology was present in the peripheral blood. Flow cytometry showed a 9% population of CD45 dim positive, CD13 partial positive, and CD15 variably positive cells. Peripheral blood FISH analysis revealed deletion 7q, gain of 8q, and deletions 16q and 17q in 32.5% to 36% of 200 interphase cells analyzed. The bone marrow biopsy showed cohesive groups of cytokeratin AE1/AE3 positive cells. Our report demonstrates that circulating carcinoma cells can mimic a high-grade myeloid neoplasm morphologically and by flow cytometry and FISH analysis.
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee WI, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rowan
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee WI, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Logunova
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee WI, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: van Tuinen
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee WI, USA.
authors.forename: Horatiu
authors.initials: H
authors.lastname: Olteanu
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee WI, USA.
authors.forename: Jess F
authors.initials: JF
authors.lastname: Peterson
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: FISH; acute leukemia; carcinoma; cytogenetics; flow cytometry