http://jcp.bmj.com/cgi/content/full/60/7/838

Journal of Clinical Pathology 2007;60:838-839; doi:10.1136/jcp.2005.033787

The divergent morphological classification of variant lymphocytes in blood smears

1 Department of Clinical Chemistry, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands
2 Department of Clinical Chemistry, Albert Schweitzer Hospital, Dordrecht, The Netherlands
3 Laboratory of Medical Pathology, Hospital Rivierenland, Tiel, The Netherlands
4 Department of Clinical Chemistry, Radboud University, Nijmegen Medical Center, The Netherlands

Correspondence to:
MrWim van der Meer
Department of Clinical Chemistry (564), Radboud University, Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; w.vandermeer@... 4 December 2005

Keywords: variant lymphocytes; atypical lymphocytes; variability

An examination of a blood smear may be requested by physicians or initiated by laboratory staff as a diagnostic aid when a lymphoproliferative disorder or mononucleosis is suspected.1 The classification of lymphocyte disorders is complex because there are various manifestations of these disorders.2,3 Three major groups can be distinguished: reactive lymphocytosis, premalignant neoplastic disorders of lymphocytes and neoplastic disorders of lymphocytes.4 Lymphocyte disorders may be accompanied by abnormal lymphocyte morphology; therefore it is important to recognise and report abnormal lymphocytes, such as atypical lymphocytes and lymphoblasts. The ability of individual technicians, however, to recognise abnormal lymphocytes is consistently quite poor.5 There are no standardised definitions regarding the morphology of the various cells, and interpretation is based on individual experience and dependent on the availability of additional clinical information. Often, transitional forms between lymphocytes and plasma cells are seen in the blood of patients with viral infections. These cells are variously . . . [Full text of this article]