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Case study of the morphologic variation of circulating tumor cells

Academic Article
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Overview

related to degree

  • Marrinucci, Dena, Ph.D. in Biology, Scripps Research 2004 - 2009

authors

  • Marrinucci, Dena
  • Bethel, Kelly
  • Bruce, R. H.
  • Curry, D. N.
  • Hsieh, B.
  • Humphrey, M.
  • Krivacic, R. T.
  • Kroener, J.
  • Kroener, L.
  • Ladanyi, A.
  • Lazarus, N. H.
  • Nieva, Jorge Javier
  • Kuhn, Peter

publication date

  • March 2007

journal

  • Human Pathology  Journal

abstract

  • We report a detailed cytomorphologic evaluation of the circulating component of widely metastatic breast carcinoma. A previously healthy 38-year-old woman was diagnosed with breast cancer. Wide local excision revealed a 1.7-cm infiltrating ductal adenocarcinoma, BSR score 7/9 with angiolymphatic invasion, and 4/20 lymph nodes positive for carcinoma. Five years later, a bone marrow biopsy revealed involvement of bone marrow by metastatic breast carcinoma, and shortly thereafter, metastases were identified in the liver and lung hilum. She enrolled in a clinical investigation for the detection of circulating tumor cells (CTCs) in breast carcinoma. A total of 659 CTCs were identified in a 10-mL blood sample using an immunofluorescent protocol targeting cytokeratins and detected using fiber-optic array scanning technology. The detected CTCs were subsequently stained with a Wright-Giemsa stain, and representative cells were evaluated in detail by light microscopy for morphologic evaluation. We find that the patient's CTCs exhibit a high degree of pleomorphism including CTCs with high and low nuclear-to-cytoplasmic ratios along with CTCs exhibiting early and late apoptotic changes. In addition, in comparison with her tumor cells in other sites, the full morphologic spectrum of cancer cells present in primary and metastatic tumor is also present in peripheral blood circulation.

subject areas

  • Adult
  • Bone Neoplasms
  • Breast Neoplasms
  • Carcinoma, Ductal, Breast
  • Cytophotometry
  • Fatal Outcome
  • Female
  • Fiber Optic Technology
  • Humans
  • Neoplastic Cells, Circulating
  • Optical Fibers
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Research

keywords

  • Wright-Giemsa stain
  • breast cancer
  • circulating tumor cells
  • cytokeratin
  • fiber-optic array scanning technology
  • metastasis
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Identity

International Standard Serial Number (ISSN)

  • 0046-8177

Digital Object Identifier (DOI)

  • 10.1016/j.humpath.2006.08.027

PubMed ID

  • 17188328
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Additional Document Info

start page

  • 514

end page

  • 519

volume

  • 38

issue

  • 3

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