6. Lymphoblasts vs. Atypical Lymphocytes
The differentiation between atypical lymphocytes and leukemic blasts
may, on occasion, be quite difficult; however, as the two pictures
(100x) in this image demonstrate, there are significant morphologic
differences. Blasts often have a very high N/C (nuclear to
cytoplasmic) ratio and stippled chromatin pattern. Atypical
lymphocytes, as a rule, have abundant cytoplasm and coarser
chromatin. The clinical and hematologic changes associated with these
cases are helpful in this differentiation as well. Leukemic blasts,
as seen in acute leukemia, tend to infiltrate the marrow and suppress
the production of normal hematopoietic elements.
