Mystery cells, case #12

Can anyone tell us the diagnosis?

The cells in this case were collected from a blood film run on a CellaVision®DM96 at Northern Plains Laboratory Bismarck, North Dakota, US.

The patient details are as follows:
84 year old male
WBC 30.7 x 10^9/l
RBC 3.72 x 10^12/l
Hemoglobin 112 g/l
HCT 34.1%
MCV 92  fl
PLT 131 x 10^9/l

Please share your suggested diagnosis!

43 thoughts on “Mystery cells, case #12”

  1. Quite a difficult case to diagnose on a simple CellaVision capture without cell markers etc. The WBC is quite low for a PLL.
    I would favour a lymphoma (large cell) with a differential diagnosis of PLL. The 2 cells alongside the two neutrophils look
    monocytoid so couldn’t rule out a monocytoid abnormality either.

  2. linfocitos de cromatina intermedia,podria ser un linfoma o una leucemia prolinfocitica,para la tipificacion exacta debemos realizar otras pruebas como el inmunofenotipo(citometria de flujo)e identificacion de alteraciones geneticas

  3. I agree with Prolymphocytic leukemia based on N/C, large proeminent nucleole and the aspect of the chromatin and the CBC parameter at this stage.

  4. This is not easy. I favour a large cell lymphoma in leukaemic phase with prolymphocytic leukaemia to be considered. I don’t think the chromatin is sufficiently dispersed to favour acute leukaemia. The apparent granules in several cells might just be stain deposit as there are similar objects between the cells.

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