Is The Presence Of Smudge Cells In A Blood Smear Test A Concern?

Posted on Mon, 15 May 2017

Question: Daughter is 18, bloodwork shows presence of smudge cells and rouleaux. Some sources online say smudge cells indicative of CLL most common in persons over 60.Nothing else reported abnormal, including red and white counts. Bloodwork was occasioned by chronic sore throat and inflamed tonsils. Other complaints include fatigue, IBS, and "sweats." No family history of CLL or other blood and marrow cancers.

How likely is the presence of smudge cells and rouleaux to indicate CLL?

Answered by Dr. Deepak Sundriyal (2 hours later)

Brief Answer:
Hello dear. Get a repeat blood test done

Detailed Answer:
Hello dear. I have gone through the details. As rightly said, smudge cells(degenrating cells) are seen in chronic lymphocytic leukemia and rouleax formation can be seen in infections. So only point of concern is smudge cells. However, chronic lymphocytic leukemia never occurs in age below 60 years and hence reports seems to be false or some mixed up from another patient. Moreover smudge cells can be seen in normal blood also but in very low numbers, and also in infections. A repeat blood test can be done to allay the anxiety.
Thanks and regards

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Above answer was peer-reviewed by : Dr. Raju A.T