Smudge cells

[bella3011]

Would like to know if I should be concerned with a result of Smudge cell on my wbc morphology?  It also says RARE under wbc morphology...The rbc one has no comment, nor does the plat morph...I am 43, and have had combinations of sore, tender muscles, painful joints, swelling in hands, feet, around my eyes...alot of fatigue..alott..a few more things...Also, have had 3 cbc done..they the wbc keeps crawling up, along with leuks, neuts, baso etc...should i be concerned??

[bella3011]

Heyy...Thanks for checking in...I got this Friday to meet with my oncologist to get all the results..:)  Hoping for good news!  Although, it will put me back at square one if everything turns out ok, but hopefully she sticks with me and gets to the bottom of this!  Will let you kno!!..:)

[Londres70]

Sounds more and more like Lymphoma (NHL) or a blood cancer or a nasty systemic infection.  Though NHL does present like infection, so it can be difficult or take forever to diagnose.

Well, keep me be posted.  The cancers, Lymphoma or Leukemia, will pretty much be ruled out with the bone marrow aspirate results.  

[bella3011]

Have appt on the 27th to go over the results...also had a 24hr urine test over this past weekend  too...I also forgot to mention, along w/ not feeling well..the major reason I finally went to the docs, is that I had alott of swollen lymph nodes on rite side of neck...they were huge!  Most went down over the past few months..yet still remain..the cat scan showed them along with many swollen lymphs in chest area...That is the time where blood work started at just elevated..wbc at 13.2...stuff just keeps rising..symptoms same/worsening...I will let you kno what I get back for results...If..it is an infection of some sort...it is hiding prettty darn well..:(

[Londres70]

Sure, no problem helping you out.  

A systemic infection can also be the culprit.

Well, when will you be getting the results of the bone marrow aspirate?

Cancer, autoimmune and infection sources must be ruled out.  

Need the bone marrow aspirate results.

[bella3011]

No, not much for fevers..I do wake up veryy hott at times, or when i lay down for naps..i wake up sweaty...At times, I am just sitting here on the computer and have major hot flashes and skin becomes clammy...Through some of the tests that have been run..they were telling me that all of them show major sinitus in which I have absolutely no symptoms of that...have not had a cold or flu anything like that...The only thing I have noticed in that subject, is alot of thick mucus that sits towards back of throat...I do get out of breath fast when doing ANYthing physical...also get clammy at those time also...and if anything, I run pretty low on the temp...Thanks so much for getting back to me!!..:)

[Londres70]

Well.....the bone marrow aspirate should shed more light on this.

Leukemia and Lymphoma should definitely be ruled out.  The bone marrow results will answer this.  This could also be an autoimmune disorder.  

Have or are you having fevers or upper respiratory symptoms?

[bella3011]

Thanks so much for your responses!  I have not been feeling well, so I am just getting back on here...Here is the last cbc results...

wbc 18.3 was prev 18.2 prev 14.4 prev was 13.2
rbc 4.3
hgb 13.8
mch 32
mchc 33
baso 2
absolute neuts 10.2 was prev 12.2
abs lymph 5.9 prev was 4.7
abs mono 1.1 prev was 1.1
abs basos 0.4 prev was 0.2 prev was 0.0
abs eos 0.7 prev was 0.3 prev was 0.2
wbc morp showed smudge cells and Rare...others noted nothing...
platlet count is fine at 304
...C reactive protein was high for a bit but has gone down to .83 so seems to b fine now...before it was at 1.34
ANA package seems to b fine also...only noted cytoplasmic staining observed but not identified...also noted on the previous testing also...
total cpk is fine at 73

notsure if any significance...a previous mri on back cuz i was having horrible back pain..this was a while before all this started happening but it was noted on that mri result.....Depressed bone marrow signal...

Thanks so much for your time!!  Trying to get this figured out is starting to wear on me....I just wanna be back to my normal self...If you have any ideas, please share with me...I am definately open to any advice!!

[Londres70]

Yes, there is cause for concern.

Has a Hematologist/Oncologist been consulted?  

Can you give the exact WBC count along with the breakdown?  

A Bone Marrow Aspiration may be warranted.  

[Red_Star]

Smudge cells (or basket cells) are the remnant of a fragile cell (most commonly these cells are lymphoid in nature) that has been damaged in the process of making a blood smear. Smudge cells are most commonly seen in disorders characterized by lymphocyte fragility, such as chronic lymphocytic leukemia and infectious mononucleosis.

Both chronic lymphocytic leukemia and infectious mononucleosis increase the white blood count. Having more than 10,000 lymphocytes/mm³ (per cubic millimeter) of blood makes the diagnosis of CLL almost certain, although it may need to be confirmed by more specialized tests.