Smudge Cells or Basket Cell-A Diagnostic Pitfall

Smudge cells or basket cells are leukocytes that have been damaged during preparation of the peripheral blood smear. This usually occur due to the fragility of the cell and are usually seen in chronic lymphocytic leukemia(CLL) , but can be seen in various other condition also. Smudge cells are counted accurately as lymphocyte by modern blood cell analyzers. The issue of clinical significance of smudge cell is when lymphocyte doubling time is used as a prognostic factor in disease progression in chronic lymphocytic leukemia. The smudge cells on the film will not be included in manual differential, thereby resulting in an undercounting of the actual lymphocytes present. So education is needed(for the ordering physician and junior pathologist) to eliminate the risk of misinterpreting this smudge cell count as a new cell type.