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ASH Image Bank (2005); doi:10.1182/ashimagebank-2005-101340
Copyright © 2005 by the American Society of Hematology.
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Atlas Image Set

Pertussis

John Lazarchick



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  		Figure 1. 4 month old female was seen in the Emergency Room with severe respiratory symptoms. A CBC performed revealed a WBC of 78.3k/uL with a differential of 90% lymphocytes, many with irregular nuclear borders, 8% neutrophils and 2% bands. The lymphocyte predominance and atypical forms are illustrated in this view. The cells show variable amounts of cytoplasm with intense basophilic staining and absence of granules. The cell in the R bottom of the image has a cleaved nucleus.

 


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  		Figure 2. The variability in nuclear contours of the lymphocyte population can be seen in this view. The cells are of intermediate size, have basophilic cytoplasm and the nuclei vary from round to almost serrated in appearance.

 


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  		Figure 3. Similar cells are present in this view but the reactive appearance of some of the cells is evident. The lymphocyte at the bottom of the slide has the typical appearance of a reactive lymphocyte with a squared nucleus and increased basophilic cytoplasm. There is an immunoblast noted to its right with a high N/C ratio ad intense basophilic cytoplasm. Multiple small nucleoli are present.

 


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  		Figure 4. The spectrum of nuclear variability is better illustrated in this high magnification view. The chromatin staining is intermediate from that seem predominantly in mature lymphocytes and lymphoblasts in a few of the cells. The majority of the lymphocytes had a mature B-cell mmunophenotype on flow cytometric analysis. The direct fluorescence antibody test was positive for B. pertussis confirming the clinical diagnosis.

 

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Related ASH-SAP Chapter:space logo
Chapter 18: Consultative hematology

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Copyright © 2005 by the American Society of Hematology.