Cell Case #21

This Cell Case presents a 64-year-old man that arrived at an emergency ward with complaints of malaise and fatigue. Clinical chemistry parameters showed a total protein of 126 g/L, an albumin of 26 g/L and a total IgG of around 70 g/L.  Peripheral blood smear analysis displayed several aberrant cell types.


What diagnosis do you think was given in this case? Please post your suggestion!

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/ The CellaVision Blog Team

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This blog is created by CellaVision for laboratory professionals with a particular interest in hematology and digital cell morphology. Our aim is to inform, educate and inspire in equal measures – by highlighting interesting articles, sharing interesting patient cases and cell images, and presenting inspiring success stories from our community of CellaVision-users from around the world.

31 thoughts on “Cell Case #21”

  1. Immature Plasma Cell:
    Clear Golgi area around nucleus.
    Nuclear chromatin is too immature to be identified as a mature plasma cell.

  2. Multiple myeloma. The presence of plasma cells, a paraprotein elevated in
    serum (Rouleaux in blood smears) and decreased albumin. .Astenia and weakness due to decreased red blood cell count: anemia. The patient’s height may be reduced by several centimeters as a result of vertebral crushing.

  3. Rouleaux, increased protein and what looks like a plasma cell (albeit not totally typical in shape). I’d go for some plasma cell disorder possibly Myeloma.

  4. Myeloma. Plasma cell, eccentric nucleus, and deep basophilic staining of the cytoplasm. Rouleaux confirms this.

  5. Agree, looks like possibly multiple myeloma. Due to protein levels and rouleaux with characteristics of plasma cell.

  6. Myeloma is the most likely diagnosis. This is apparently large a plasma cell. The elevated immunoglobulin levels are causing the RBC rouleaux that is also noted in the picture.

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