{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:57:04Z","timestamp":1773827824727,"version":"3.50.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Carcinocythemia, known as the presence of circulating tumor cells in the peripheral blood, is difficult to detect when the carcinoma cells are minimally present. We describe a case of a 56-year-old patient presenting with disseminated\u202fintravascular coagulation (DIC) and multiple organ failure. Despite initial suspicion of sepsis, a peripheral blood smear showed the presence of atypical cells, mainly located at the feathered edge, leading to a presumptive diagnosis of carcinocythemia of unknown primary origin. The presence of a high-fluorescent cell population detected by our hematology analyzer (Sysmex XN-9100) and immunohistochemical staining with pancytokeratin AE1\/AE3 confirmed the carcinoma cell origin. The patient died 4 days after referral to our hospital. Postmortem examination revealed a pleomorphic lobular breast carcinoma (triple-negative, androgen receptor-negative). Given the clinical acuity of patients with carcinocythemia, early diagnosis is essential to guide management. This case underscores the importance of optimizing current workflows relying on complex flagging algorithms and enhanced digital imaging to aid in the early detection of such rare condition. When patients present with DIC of unknown origin and high fluorescent signals are detected on the hematology analyzer, carcinocythemia should actively be ruled out by extensive microscopic peripheral blood examination.<\/jats:p>","DOI":"10.1093\/labmed\/lmae068","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T16:52:53Z","timestamp":1724086373000},"page":"101-104","source":"Crossref","is-referenced-by-count":1,"title":["Automated feathered edge blood smear analysis: early diagnosis of carcinocythemia in a case of disseminated intravascular coagulation with multi-organ failure"],"prefix":"10.1093","volume":"56","author":[{"given":"Marth","family":"Briers","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7540-2237","authenticated-orcid":false,"given":"Marnix","family":"Mylemans","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Tousseyn","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lo Man","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedeh","family":"Tajdar","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospitals Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Microbiology, Immunology and Transplantation, University of Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3105-6117","authenticated-orcid":false,"given":"Christine","family":"Van Laer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospitals Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, University of Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"issue":"1","key":"2025010605550423900_CIT0001","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1111\/ijlh.12924","article-title":"Carcinocythemia: a rare entity becoming more common? A 3-year, single institution series of seven cases and literature review","volume":"41","author":"Ronen","year":"2019","journal-title":"Int J Lab Hematol."},{"issue":"2","key":"2025010605550423900_CIT0002","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/0002-9343(76)90437-x","article-title":"Carcinocythemia (carcinoma cell leukemia). An acute leukemia-like picture due to metastatic carcinoma cells","volume":"60","author":"Carey","year":"1976","journal-title":"Am J Med."},{"issue":"5","key":"2025010605550423900_CIT0003","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1111\/ijlh.14112","article-title":"Carcinocythemia in metastatic breast cancer detected by high fluorescent signals on an automated Sysmex XN-9100 hematological cell counter","volume":"45","author":"Vanrenterghem","year":"2023","journal-title":"Int J Lab Hematol."},{"issue":"2","key":"2025010605550423900_CIT0004","doi-asserted-by":"publisher","first-page":"e8471","DOI":"10.1002\/ccr3.8471","article-title":"Massive circulating metastatic cells: a case of carcinocythemia","volume":"12","author":"Farkh","year":"2024","journal-title":"Clin Case Rep."},{"key":"2025010605550423900_CIT0005","doi-asserted-by":"publisher","first-page":"102721","DOI":"10.1016\/j.bcmd.2022.102721","article-title":"Neoplastic bone marrow invasion: rapid exclusion of hematological disease by flow cytometric routine panels","volume":"99","author":"Bisegna","year":"2023","journal-title":"Blood Cells Mol Dis."},{"issue":"11","key":"2025010605550423900_CIT0006","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.5858\/arpa.2012-0603-RS","article-title":"Pleomorphic lobular carcinoma of the breast: a morphologically and clinically distinct variant of lobular carcinoma","volume":"137","author":"Butler","year":"2013","journal-title":"Arch Pathol Lab Med."}],"container-title":["Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/56\/1\/101\/58853681\/lmae068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/56\/1\/101\/58853681\/lmae068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T05:55:08Z","timestamp":1736142908000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/labmed\/article\/56\/1\/101\/7736037"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,19]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,8,19]]},"published-print":{"date-parts":[[2025,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/labmed\/lmae068","relation":{},"ISSN":["0007-5027","1943-7730"],"issn-type":[{"value":"0007-5027","type":"print"},{"value":"1943-7730","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,8,19]]}}}