Many different scenarios can lead to smudge cells on a slide, but because the presence of smudge cells traditionally implies CLL, it is not currently standard practice in the United States to report smudge cells in any context other than CLL, and then usually only as “present,” without quantitation or grading. Smudge cell reporting requires the agreement and understanding of the communityhematology
Hematology
Hematology, also spelled haematology, is the branch of medicine concerned with the study, diagnosis, treatment, and prevention of diseases related to blood. Hematology includes the study of etiology.
What are smudge cells in CLL?
· Do smudge cells always indicate CLL? Many different scenarios can lead to smudge cells on a slide, but because the presence of smudge cells traditionally implies CLL, it is not currently standard practice in the United States to report smudge cells in any context other than CLL, and then usually only as “present,” without quantitation or grading. Click to see full …
Is there clinical significance to the number of smudge cells seen?
Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is …
Are smudge cells a sign of lymphoproliferative disorders?
· The appearance of smudge cells on a peripheral-blood smear is a characteristic feature of CLL, with virtually all patients demonstrating at least some degree of smudging. 13,23 In contrast, smudge cells are a rare and inconsistent feature of other lymphoproliferative disorders. 24 Since its description in 1896 by Gumprecht, smudge cells were thought to be just …
Does smudge cell percentage correlate with vimentin expression in chronic lymphocytic leukemia?
· Why do smudge cells appear in CLL? Smudge cells are also observed; smudge cells are the artifacts produced by the lymphocytes damaged during the slide preparation. Peripheral blood flow cytometry is the most valuable test to confirm a diagnosis of chronic lymphocytic leukemia (chronic lymphoid leukemia, CLL).
Do smudge cells mean CLL?
Smudge cells are ruptured chronic lymphocytic leukemia (CLL) cells appearing on the blood smears of CLL patients. Our recent findings suggest that the number of smudge cells may have important biologic correlations rather than being only an artifact of slide preparation.
What does it mean when smudge cells are present?
Smudge cells are remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as chronic lymphocytic leukemia (CLL).
Can you have smudge cells and not have cancer?
Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear.
What is the most important lab finding with chronic lymphocytic leukemia?
Flow cytometry, also called immunophenotyping, is the most important test to confirm a diagnosis of CLL.
What accounts for the frequent smudge cells in CLL?
Chronic lymphocytic leukemia (CLL) is the most commonly encountered leukemia in the clinical laboratory. Cytoskeletal defects in CLL lymphocytes can result in the formation of up to 75% smudge cells (SCs) during blood film preparation.
Are smudge cells diagnostic?
While smudge cells are not diagnostic of CLL, it has been shown that, in newly diagnosed CLL, a larger percentage of smudge cells is a better prognostic factor. Patients with >30% smudge cells show longer times before requiring treatment and longer survival rates than patients with fewer smudge cells.
What infections cause smudge cells?
Abstract. The smudge cells are well studied as a prognostic factor for chronic lymphocytic leukemia, but it is also found in viral infections. We experienced a case of abnormal hyperleukocytosis (WBC 41,600/mm3) associated with infectious mononucleosis (IM).
What percentage of lymphocytes indicates leukemia?
To be diagnosed with CLL, there must be at least 5,000 monoclonal lymphocytes (per mm3) in the blood. For it to be called SLL, the patient must have enlarged lymph nodes or an enlarged spleen with fewer than 5 ,000 lymphocytes (per mm3) in the blood.
Is lymphocytosis the same as CLL?
People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes (lymphocytosis), but the leukemia cells don't fight infection the way normal white blood cells do.
What test confirms CLL?
The main test used to help diagnose CLL is a type of blood test called a full blood count. This is where the number and appearance of the different blood cells in a sample of your blood are checked in a laboratory. An abnormally high number of unusual white blood cells (lymphocytes) can be a sign of CLL.
Can a CLL diagnosis be wrong?
Physicians often fail to diagnose chronic leukemia, as it often shows no symptoms until the disease has begun to progress. Many of the symptoms of leukemia may also be symptoms of other illnesses, which results in a high number of misdiagnoses.
What lab values indicate CLL?
People with CLL have too many lymphocytes. (This may be called lymphocytosis.) Having more than 10,000 lymphocytes/mm³ (per cubic millimeter) of blood strongly suggests CLL, but other tests are needed to know for sure. You might also have low levels of red blood cells and platelets.
What are Smudge Cells?
Normally, cells have well defined structures with an easily identifiable cytoplasmic membrane. However, there are these abnormal bunches of cells which are called as smudge cells that do not have this well-defined boundary. They are actually the remains of the dead lymphocytes that have combined together into groups.
What Causes Smudge Cells?
To understand the reason behind the formation of smudge cells, we need to first discuss about a condition known as Chronic Lymphocytic Leukemia (CLL). This abnormal condition results due to excess production of lymphocytes by bone marrow.
Differential Diagnosis of Smudge Cells
The differential diagnosis of the smudge cells involves counting the lymphocytes to find out its relative differential count. It is usually 0.24 which is sometime represented as 24% of the total number of white blood cells present in the body.
What Causes Smudge Cells?
Before we talk about the causes of Smudge Cell formation, we have to discuss Chronic Lymphocytic Leukemia (CLL) first. This type of cancer occurs when too many lymphocytes are produced by the bone marrow.
The Differential Diagnosis of Smudge Cells
Upon counting Lymphocytes, the relative differential is 0.24, which is basically rounded off as 24% of the white blood cells.