Blast Morphology in Peripheral Blood Smear

Clinical case review: differential diagnosis of binucleated blasts and large granular lymphocytes in a peripheral blood smear from a 68-year-old woman.

Evgeny Zaytsev 1 min January 16, 2021

Blood smear: blast cell with a bilobed nucleus

Blood smear: blasts with a bilobed nucleus and basophilic cytoplasm

Blood smear: blast cells with delicate chromatin and vacuolization

Blood smear: typical blast with a high nuclear-to-cytoplasmic ratio

Blood smear: atypical blast cell with large intranuclear vacuoles

Blood smear: two blast cells with eccentrically located nuclei

Blood smear: round blast with diffuse chromatin distribution

Blood smear: blasts with prominent clefting and nuclear invaginations

A case from my practice. Regarding the binucleated lymphocyte (post below). All photos were taken from the peripheral blood smear of one patient (a 68-year-old woman). If you look at the other cells, it becomes clear that this is not a large granular lymphocyte with 2 nuclei (first photo), but a blast cell. Therefore, it is necessary to see the whole picture to make a conclusion. And to judge the class of cells by evaluating the morphology of other leukocytes and clinical data (age especially).