On peripheral smear of a patient with CLL, smudge (basket) cells are seen. These result from:

• A Complement-mediated lysis of circulating B cells
• B Spontaneous apoptosis of leukemic cells releasing nuclear contents
• C Phagocytosis of lymphocytes by activated macrophages
• D Mechanical fragility of neoplastic lymphocytes during smear preparation ✓

Explanation

Smudge cells (basket cells) are a hallmark of CLL peripheral smear and result from mechanical disruption of fragile neoplastic lymphocytes during slide preparation, leaving smeared nuclear remnants without cytoplasm. This fragility reflects the abnormal cytoskeletal properties of CLL B-cells. The number of smudge cells inversely correlates with vimentin expression and has prognostic implications.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.