Margit grome

The diagnosis for mystery case #3

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 »

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Mystery cells, case #3

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 »

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