Page 205 - Clinical Hematology Atlas

CHAPTER 19 MATURE LYMPHOPROLIFERATIVE DISORDERS 189

C D
FIGURE 19–1C Small lymphocytes with smudge FIGURE 19–1D (BM 3500).
cell (PB 31000).

MORPHOLOGY
Peripheral Blood: Mature-appearing lymphocytes with round nuclei and block-type chromatin;
inconspicuous nucleoli, scant cytoplasm; homogeneous appearance within a given patient;
lymphocytes more fragile than normal, leading to “smudge” cells
Absolute sustained lymphocytosis
6 Normocytic normochromic anemia (approximately 10% of patients develop an
autoimmune hemolytic anemia)
6 Thrombocytopenia
Bone Marrow: $30% lymphocytes
IMMUNOPHENOTYPE
CD20 , CD19 , CD5 , CD23 1
1
1
1
NOTE: Addition of albumin to blood prior to smear preparation stabilizes CLL cells, decreasing
the formation of smudge cells and allows for accurate cell classification.