Chase the Case #59 - Chronic Lymphocytic Leukemia

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Yumizen H2500 Hematology Analyzer

August 2026 (PDF for print)

Patient Demography: Female, 67 years old

Symptom: Fatigue and weakness

Diagnosis: Chronic Lymphocytic Leukemia confirmed by immunophenotyping.

Microscopic Review: Lymphocytes 92%, Neutrophils 5%, Monocytes 2%, Prolymphocytes 1%. Microscopy shows the presence of mature-appearing lymphocytes with round nuclei and dense, clumped chromatin. A few atypical lymphocytes, along with smudge cells (Gumprecht shadows), are also seen.

How Yumizen can assist: On the DIFF-LMNE matrix, we observe a tight cluster of cells in the lymphocytic region, which appears stretched as a tail toward the ALY & IML regions of the immature matrix. The ALY value in the differential calculation is also elevated above the upper limit of the reference range, and these parameters raise an alarm prompting the user to investigate a lymphocytic-origin abnormality. On the BASO histogram, we observe large cells on the right side of the curve, corresponding to the abnormal cell forms seen in Chronic Lymphocytic Leukemia and correlating with the ALY alarm.

Mature-appearing lymphocytes with round nuclei and dense, clumped chromatin. 
A few atypical lymphocytes, along with smudge cells (Gumprecht shadows), are also seen.

 

This clinical case has been provided by Dr. Arthur Imbach, LPA - Laboratoire de Biologie, Besançon, France.

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