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Scientific Editorial Group
Margit grome
The diagnosis for mystery case #3
We gave out the result:
21.0% Segmented neutrophil
0.3% Eosinophil
0.5% Basophil
61.7% Lymphocyte (With comment: “activated”)
5.3% Monocyte
0.5% Myelocyte
10.3% Other (with comment: “Atypical mononuclear cells with immature appearance (Virucytes?)) “
I called the department and asked if they suspected infectious mononucleosis. I have seen mononucleosis-cells before, but as I recall they look more like large, activated lymphocytes.
The answer was yes, and 2 days later, the diagnosis was confirmed by a positive Epstein -Barr test (EBV).
Normally we do not have this kind of “benign” disease at Rigshospitalet. Usually, we look for malignant haematological diseases.
In 1923, Downey divided the atypical lymphocytes into 3 types. But of … Read more »
Mystery cells, case #3
This interesting mystery cells case is presented by Margit Grome, Biomedical Laboratory Scientist, Department of Clinical Biochemistry at Rigshospitalet, Copenhagen University Hospital.
Here are the patient details:
A 4 year-old boy, hospitalized at the Department of Paediatrics.
Cell count at the Sysmex XE-2100 showed, click to enlarge.
The Sysmex XE-2100 could not perform a differential count but gave the alarm:
“Atypical Lympho ? and Abn Lympho/L_Blasts?”
We validated 400 cells in the CellaVision DM96. We were a bit surprised to see 10% of – rather immature looking – mononuclear cells.
Click to enlarge the cells.
What diagnosis do you suspect? Discuss with your colleagues … Read more »