Splenic B cell lymphoma with lymphocyte clusters in peripheral blood smears

Area of Science:

• Hematology
• Oncology
• Clinical Pathology

Background:

• Ethylenediaminetetraacetic acid (EDTA) is a common anticoagulant used in blood collection.
• EDTA-induced lymphoid cell clumping is a rare phenomenon, complicating laboratory diagnosis.
• Accurate identification of benign and malignant lymphoid cells is crucial for patient management.

Observation:

• A rare case of low-grade B cell splenic lymphoma presented with significant lymphocyte clumping.
• Clumping occurred in peripheral blood smears prepared from EDTA-anticoagulated samples.
• This represents the fourth reported instance of neoplastic lymphoid cells forming in vitro clusters.

Findings:

• The observed lymphocyte clumping was directly associated with EDTA anticoagulant.
• Neoplastic lymphoid cells from a splenic lymphoma exhibited in vitro aggregation.
• The phenomenon was documented in peripheral blood smears.

Implications:

• EDTA-induced lymphoid cell clumping can mimic other hematologic conditions, necessitating careful interpretation.
• The association with splenic lymphomas, though infrequent, warrants further investigation.
• Understanding this artifact is vital for accurate hematopathological diagnosis and avoiding misdiagnosis.