Case Study Five

A 42-year-old male visited his physician because of recent increased bruising. A complete blood count (CBC) was ordered, which revealed a decrease in platelets. A peripheral blood smear was reviewed and approximately 10% of the white blood cells (WBC) were consistent with the WBC in the image on the right. The image is a representative field of the Wright-Giemsa stained smear (1000X magnification). Note the absence of platelets on the smear.

The cell indicated by the arrow is a plasma cell. An increase in circulating plasma cells usually indicates a chronic infection or autoimmune disorder in which an increase in plasma proteins is found. Although multiple myeloma must be ruled out, the cell on display is mature, and benign conditions should be excluded first.