Circulating Breast Carcinoma Cells Mimicking Therapy-Related Acute Myeloid Leukemia

This is the authors' abstract. We don't add key points for this paper.

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.