SPURIOUS LEUKOCYTOSIS LEADS TO A DIAGNOSIS

Fifty years old female presented with cervical lymphadenopathy, headache, and weight loss for 2 weeks. On examination, she had purpuric spots. Investigations revealed erroneous counts revealing interference by cryoglobulin. Lymphoplasmacytic lymphoma was suspected because of cryoglobulin interference, purpuric spots, and lymphadenopathy. The lymph node showed atypical small lymphocytes admixed with plasma cells. The cells were positive for CD45, CD20, CD79a, PAX-5, MUM-1 & Kappa conrmed the diagnosis. Careful evaluation of histogram and scatterogram in a patient with leukocytosis indicated interference by cryoglobulin, which leads to further investigation. The pathologist is responsible for differentiating spurious leukocytosis from leukocytosis so the underlying condition can be diagnosed and managed.