The divergent morphological classification of variant lymphocytes in blood smears

摘要

An examination of a blood smear may be requested by physicians or initiated by laboratory staff as a diagnostic aid when a lympho-proliferative disorder or mononucleosis is suspected. The classification of lymphocyte disorders is complex because there are various manifestations of these disorders. Three major groups can be distinguished: reactive lymphocytosis, premalignant neoplastic disorders of lymphocytes and neoplastic disorders of lymphocytes. 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. 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.