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Poikilocytosis Associated With Carcinoma

JOHN FORSHAW, MD; LILIAN HARWOOD
Arch Intern Med. 1966;117(2):203-205. doi:10.1001/archinte.1966.03870080047008.
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A PECULIAR red blood cell with one or more large spiny projections along its periphery was designated "burr" cell by Schwartz and Motto.1 These cells were observed in the blood of 73% of patients with uremia, 68% of patients with carcinoma of the stomach, and 54% of patients with bleeding peptic ulcer. Brain et al 2 described 18 patients with acute renal failure and five with disseminated carcinoma, who developed overt hemolytic anemia and a bizarre blood picture characterized by numerous contracted, distorted, and fragmented red cells. Although these morphological abnormalities are now a well recognized feature in acute renal failure they are still regarded as unusual in cases of carcinoma and are not described in standard textbooks of hematology.3,4 In the present paper we describe 17 cases of carcinoma, in which there was striking poikilocytosis.

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