This is a third example of the peripheral blood in CLL. The nuclear chromatin of most of the lymphocytes is heavily clumped, and may have very little cytoplasm. Nucleoli are not conspicuous in this example. "Smudge" cells are seen in this field and were frequently found in other microscopic fields of this peripheral blood smear. Smudge cells are commonly found in the blood smears of patients with CLL, but they are not pathognomonic and may be seen in other leukemias, especially ALL. Smudge cells apparently result when the fragile leukemic cells are spread on glass slides. When "spinner" methods are used to prepare blood films, far fewer of these damaged cells result.
Course Section: 07. Lymphocytic Leukemia: Acute and Chronic
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