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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
HM. Kuerer's
Surgical Oncology;
2010 Available
May 05,
small, pin-point
is typically
seen Breast
in the hematopoietic
cell cytoplasm
(H), at:
larger vacuoles Accessed:
may be present
actual tumor cells (A).
"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