Evaluation of apoptotic leukocytes in peripheral blood smears.
OBJECTIVE
Apoptosis is a phenomenon of physiological cell death in which each step is regulated, similar to the process of mitosis. We observed apoptosis in leukocytes during the review of peripheral blood smears. This study was undertaken to evaluate the morphologic features of apoptotic leukocytes in peripheral blood smears and to ascertain their clinical significance.


METHODS
Sixty cases (23 males and 37 females, aged newborn to 92 years) exhibiting apoptotic leukocytes in peripheral blood smears were studied. Medical records for each case were reviewed, and patients were categorized according to their clinical diagnoses.


RESULTS
Neutrophils were the most common apoptotic leukocytes identified (85%), followed by lymphocytes (18%) and eosinophils (2%). The diagnosis most frequently associated with the presence of apoptotic leukocytes was infection (55%). Apoptosis in lymphocytes was comparatively less common, but when present, the most common associations were diabetes mellitus, glucocorticoid administration, and neoplastic diseases.


CONCLUSIONS
Our findings suggest that the presence of apoptotic leukocytes in peripheral blood smears may help in the differential diagnosis and may be related to the severity of disease. We recommend further evaluation using additional special techniques for detecting apoptotic leukocytes.
Shidham
V B
VB
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Swami
V K
VK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007239:Infections / Q000097:blood; D007958:Leukocyte Count; D007962:Leukocytes / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood; D009504:Neutrophils / Q000473:pathology
D005938:Glucocorticoids