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Categorization of immunostained cells for the detection of breast carcinoma cells in bone marrow and peripheral blood. "Tumor cell," pathognomonic features of epithelial tumor cell nature, with a clearly enlarged nucleus compared with the size of neighboring hematopoietic cells (A) and/or the formation of clearly immunostained tumor cell doublets/clusters (B), a morphology never observed in false-positive hematopoietic cells or in negative control specimens. "Probable tumor cells" represent a morphologic overlap between tumor cell and hematopoietic cell, lacking pathognomonic features of tumor cells, but morphologic signs of hematopoietic cell are also absent; typically cytoplasmic staining is strong (C,D), often irregularly distributed (D), and clearly overlaying the nucleus (C,D). "Hematopoietic cells" (so-called false positives): typical hematopoietic cell features include a small, hematopoietic cell-sized Source: Chapter 27. Minimal Residual Cancer, Kuerer's Breast Surgical Oncology nucleus (E–H) with an even or regularly distributed cytoplasmic staining (G,H), which often is microvacuolar (G) and not overlying the nucleus (E,G,H); a Citation: Kuerer HM. Kuerer's Surgical Oncology; 2010 Available http://mhmedical.com/ May 05, small, pin-point vacuole is typically seen Breast in the hematopoietic cell cytoplasm (H), at: whereas larger vacuoles Accessed: may be present in2017 actual tumor cells (A). Copyright © 2017 McGraw-Hill Education. All rights reserved "Destroyed/degenerated tumor cells" are tumor cells that show morphologic signs of degeneration and or destruction (I,J). (Adapted and reproduced with permission from Borgen E, Naume B, Nesland JM, et al. Standardisation of the immunocytochemical detection of cancer cells in bone marrow and blood: I. Establishment of objective criteria for the evaluation of immunostained cells. Cytotherapy. 1999;1:377-388. and Naume B, Wiedswang G, Borgen E, et