Here’s a case that involves a very pretty cell. Once you know what this cell is, you won’t forget it – it’s that unusual and memorable!  If you want to test yourself with other unknown cases, here are some to try:

  • Case 1: 20-year-old male who died suddenly
  • Case 2: 72-year-old male with right calf mass
  • Case 3: 67-year-old female with pancytopenia
  • Case 4: 59-year-old male with severe headaches
  • Case 5: 38-year-old female with deep venous thrombi
  • Case 6: 13-year-old male with cerebellar mass
  • Case 7: 45-year-old male with pulmonary emphysema
  • Case 8: 38-year-old male with AIDS and headaches
  • Case 9: 25-year-old male with arm mass

Back to this case. Take a look at the photo and the question, then scroll down for the answer.

unknown 062613

A 57-year-old male presents with fatigue and left upper quadrant heaviness. His white blood cell count is 110 x 109/L, and his hemoglobin is 8 g/dL. A bone marrow biopsy is performed, and in addition to a marked increase in neutrophils and precursors, a rare cell such as the one depicted here is present. What is this cell?

A. Malignant plasma cell
B. Megakaryocyte
C. Metastatic carcinoma cell
D. Pseudo-Gaucher cell
E. Stromal cell


(Scroll down for the answer)




This cell is a pseudo-Gaucher cell, a histiocyte with pale blue, needle-like inclusions, which resembles the foamy, glucocerebroside-stuffed macrophage characteristic of Gaucher disease. Here is a real Gaucher cell:

 gaucher cell


Back to the pseudo-Gaucher cell. Pseudo-Gaucher cells are occasionally seen in chronic myeloid leukemia, as was the case in this patient (you might have guessed that the patient had CML from the fatigue, splenomegaly, and massive leukocytosis with neutrophilia). They have also been described in other various hematologic disorders, such as myeloma, lymphoma, myelodysplastic syndromes, and thalassemia.