Quantitative Cytologic Descriptors to Differentiate CLL, Sézary, Granular, and Villous Lymphocytes through Image Analysis

Objectives: We aimed to find descriptors to identify chronic lymphocytic leukemia (CLL), Sézary, granular, and villous lymphocytes among normal and abnormal lymphocytes in peripheral blood. Methods: Image analysis was applied to 768 images from 15 different types of lymphoid cells and monocytes to determine four discriminant descriptors. For each descriptor, numerical scales were obtained using 627 images from 79 patients. An assessment of the four descriptors was performed using smears from 209 new patients. Results: Cyan correlation of the nucleus identified clumped chromatin, and standard deviation of the granulometric curve of the cyan of the nucleus was specific for cerebriform chromatin. Skewness of the histogram of the u component of the cytoplasm identified cytoplasmic granulation. Hairiness showed specificity for cytoplasmic villi. In the assessment, 96% of the smears were correctly classified. Conclusions: The quantitative descriptors obtained through image analysis may contribute to the morphologic identification of the abnormal lymphoid cells considered in this article.