In the CLL case, which smear finding is reported?

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Multiple Choice

In the CLL case, which smear finding is reported?

In CLL, the peripheral blood smear classically shows lymphocytosis with numerous fragile lymphocytes that are easily disrupted during smear preparation, producing smudge cells (Gumprecht shadows). This combination—especially the abundant smudge cells—is highly characteristic of the disease. Rouleaux formation reflects stacking of red blood cells due to higher serum proteins, seen in inflammatory states or plasma cell disorders, not the leukemic lymphocytes of CLL. Atypical lymphocytes can appear in various infections or leukemias but the typical CLL smear features are small, mature-appearing lymphocytes with many smudge cells. Platelet aggregation is an artifact and not a defining finding of CLL.

In CLL, the peripheral blood smear classically shows lymphocytosis with numerous fragile lymphocytes that are easily disrupted during smear preparation, producing smudge cells (Gumprecht shadows). This combination—especially the abundant smudge cells—is highly characteristic of the disease. Rouleaux formation reflects stacking of red blood cells due to higher serum proteins, seen in inflammatory states or plasma cell disorders, not the leukemic lymphocytes of CLL. Atypical lymphocytes can appear in various infections or leukemias but the typical CLL smear features are small, mature-appearing lymphocytes with many smudge cells. Platelet aggregation is an artifact and not a defining finding of CLL.

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