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What is this large polynucleated cell?

Unlike circulating tumor cells (CTCs), the cytokeratin stain (green) expression is smooth without a pattern.

Cancer Associated Macrophage-Like Cell (CAML) was named because of CD14 expression.

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CAML Characteristics

Very large: 25-300 microns in size


Markers and DNA of engulfed tumor material


Giant CAMLs are found in all major solid tumors and they appear in all stages of cancer

Examples of Giant CAMLs

Other cancer associated markers found in blood of cancer patients:

  • Circulating tumor cells (CTCs)

  • Circulating endothelial cells (CECs)

  • Epithelial mesenchymal transition cells (EMTs)

  • Circulating tumor DNA (ctDNA)

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Circulating Tumor Cells (CTCs)

Found primarily in late stage breast, prostate and colorectal cancers

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True CTCs

Cancerous nucleus morphology

CK 8, 18, 19 (+) with filamentous pattern

CD45 (-)

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Apoptotic CTCs

Degraded nuclei

CK 8, 18, 19 fragmented into spots

CD45 (-)

Size differences between CAMLs and CTCs

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Giant CAMLs are found in all stages of solid tumors, and are more prevalent than CTCs.

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