{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:10:22Z","timestamp":1778670622890,"version":"3.51.4"},"reference-count":101,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Carcinocythemia, or carcinoma cell leukemia, is a rare but striking manifestation of advanced malignancy in which circulating tumor cells (CTCs) are visible in peripheral blood (PB) smears using conventional staining. It is typically associated with advanced stage disease and poor prognosis. This review updates current knowledge on the pathophysiology, cytological features, detection methods, and clinical relevance of carcinocythemia. It explores mechanisms such as bone marrow infiltration, splenic dysfunction, and immune evasion that may facilitate tumor cell release into circulation. Morphologically, CTCs are large atypical cells often mistaken for hematologic blasts, with features that vary by tumor type. Immunocytochemistry using cytokeratins and epithelial markers (e.g. AE1\/AE3, EpCAM) is crucial for confirmation. While most cases involve breast or lung cancer, other malignancies, ranging from melanoma to rhabdomyosarcoma, have also been implicated. Carcinocythemia often mimics acute leukemia and coexists with disseminated intravascular coagulation or thrombosis. To date, 95 cases have been reported, but its true prevalence may be underestimated. Recognition of this phenomenon in PB smear reviews is critical for accurate diagnosis and prognostication, especially in acutely ill or cytopenic patients. Further research is needed to elucidate its biology and clinical implications.<\/jats:p>","DOI":"10.1515\/almed-2025-0169","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:52:35Z","timestamp":1773759155000},"page":"90-104","source":"Crossref","is-referenced-by-count":0,"title":["Carcinocythemia detection in peripheral blood smears: a literature review"],"prefix":"10.1515","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0777-6998","authenticated-orcid":false,"given":"Javier","family":"Laguna","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Genetics , 16493 CDB, Hospital Cl\u00ednic de Barcelona , Barcelona , Spain"},{"name":"Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona-Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1889-8889","authenticated-orcid":false,"given":"Anna","family":"Merino","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Genetics , 16493 CDB, Hospital Cl\u00ednic de Barcelona , Barcelona , Spain"},{"name":"Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona-Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain"},{"name":"CORE Laboratory , CDB, Hospital Cl\u00ednic de Barcelona , Barcelona , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"2026051310150652514_j_almed-2025-0169_ref_001","doi-asserted-by":"crossref","unstructured":"Carey, RW, Taft, PD, Bennett, JM, Kaufman, S. Carcinocythemia (carcinoma cell leukemia). An acute leukemia-like picture due to metastatic carcinoma cells. Am J Med 1976;60:273\u20138. https:\/\/doi.org\/10.1016\/0002-9343(76)90437-x.","DOI":"10.1016\/0002-9343(76)90437-X"},{"key":"2026051310150652514_j_almed-2025-0169_ref_002","unstructured":"Ashworth, TR. A case of cancer in which cells similar to those in the tumours were seen in the blood after death. Australas Med J 1869;14:146\u20137."},{"key":"2026051310150652514_j_almed-2025-0169_ref_003","doi-asserted-by":"crossref","unstructured":"de Wit, S, van Dalum, G, Terstappen, LWMM. Detection of circulating tumor cells. Scientifica (Cairo) 2014;2014:1\u201311. https:\/\/doi.org\/10.1155\/2014\/819362.","DOI":"10.1155\/2014\/819362"},{"key":"2026051310150652514_j_almed-2025-0169_ref_004","doi-asserted-by":"crossref","unstructured":"Thomas-Bonafos, T, Pierga, JY, Bidard, FC, Cabel, L, Kiavue, N. Circulating tumor cells in breast cancer: clinical validity and utility. npj Breast Cancer 2024;10:1\u201310. https:\/\/doi.org\/10.1038\/s41523-024-00706-7.","DOI":"10.1038\/s41523-024-00706-7"},{"key":"2026051310150652514_j_almed-2025-0169_ref_005","doi-asserted-by":"crossref","unstructured":"Chang, YH, Hsieh, RK, Chang, MC, Chen, GS. Breast cancer with an unusual leukemia-like presentation: case report and literature review. Med Oncol 2008;25:100\u20133. https:\/\/doi.org\/10.1007\/s12032-007-0048-2.","DOI":"10.1007\/s12032-007-0048-2"},{"key":"2026051310150652514_j_almed-2025-0169_ref_006","doi-asserted-by":"crossref","unstructured":"Ronen, S, Kroft, SH, Olteanu, H, Hosking, PR, Harrington, AM. Carcinocythemia: a rare entity becoming more common? A 3-year, single institution series of seven cases and literature review. Int J Lab Hematol 2019;41:69\u201379. https:\/\/doi.org\/10.1111\/ijlh.12924.","DOI":"10.1111\/ijlh.12924"},{"key":"2026051310150652514_j_almed-2025-0169_ref_007","doi-asserted-by":"crossref","unstructured":"Suner, L, Sourdeau, E, Ranaweera, T, Tarfi, S, Ronez, E, Trichet, C, et al.. Clinical and biological characteristics of patients presenting with carcinocythaemia: a retrospective, multicentre study by the french-speaking cellular hematology group (GFHC). Br J Haematol 2024;205:2041\u20134.","DOI":"10.1111\/bjh.19728"},{"key":"2026051310150652514_j_almed-2025-0169_ref_008","doi-asserted-by":"crossref","unstructured":"Lin, D, Shen, L, Luo, M, Zhang, K, Li, J, Yang, Q, et al.. Circulating tumor cells: biology and clinical significance. 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Carcinocythemia in metastatic breast cancer detected by high fluorescent signals on an automated sysmex XN-9100 hematological cell counter. Int J Lab Hematol 2023;45:625\u20137. https:\/\/doi.org\/10.1111\/ijlh.14112.","DOI":"10.1111\/ijlh.14112"},{"key":"2026051310150652514_j_almed-2025-0169_ref_022","doi-asserted-by":"crossref","unstructured":"Zhang, Y, Li, X, Li, X, Li, X, Gan, W, Li, T. Concurrent carcinocythemia, chest wall and right knee joint involvement in ewing sarcoma. Pediatr Blood Cancer 2023;70:10\u20132. https:\/\/doi.org\/10.1002\/pbc.30519.","DOI":"10.1002\/pbc.30519"},{"key":"2026051310150652514_j_almed-2025-0169_ref_023","doi-asserted-by":"crossref","unstructured":"Singh, A, Kushwaha, R, Verma, SP, Singh, US. A follow-up case of breast carcinoma with the unusual visitor in peripheral blood: unlock feathered edge secret. 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