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# Gaucher or pseudo-Gaucher cells

Gurpreet Kaur¹*, Ankur Ahuja¹, Ganesh Kumar Vishwananthan¹ and Arijit Sen¹

The patient, a 65-year-old man, presented with a pro-
longed history of upper abdominal discomfort, anorexia,
and weight loss. Examination revealed splenomegaly
15 cm below the left costal margin. There was leukocy-
tosis with moderate anemia. Bone marrow examination
revealed hypercellular marrow with a myelogram that
showed: myeloblasts 02%; promyelocytes 02%; mye-
locytes 28%; metamyelocytes 17%; band forms 20%;
neutrophils 20%; and basophils 5%, eosinophils 03%,
lymphocytes 03%. There was a mild increase in mega-
karyocyte number with occasional dwarf forms, and
numerous pseudo-Gaucher cells with a crumpled tissue
paper appearance were seen. Reverse transcription-PCR
for BCR-Abl was positive for p210 transcript. Pseudo-
Gaucher cells occur in a variety of conditions, such as
sickle cell anemia, congenital dyserythropoietic ane-
mias, immune thrombocytopenia, acute lymphoblastic
leukemia, multiple myeloma, myelodysplasia, Hodgkin's
disease, thalassemia, and disseminated mycobacterial
infection. Pseudo-Gaucher cells cannot be distinguished
from true Gaucher cells by routine hematoxylin-eosin
staining; however, iron stain can be used to differentiate
them, in which case Gaucher cells exhibit diffuse iron
staining whereas pseudo-Gaucher cells do not. Electron
microscopy shows that Gaucher cells contain typical
tubular cytoplasmic inclusions absent in pseudo-Gaucher
cells. The knowledge of possible associations, appropriate
immunohistochemistry, and relevant additional investi-
gations are necessary for final diagnosis (Fig. 1).

<figure><img src="image_2.png" /><figcaption>**Fig. 1** Aggregates of Pseudo-gaucher or histiocytes with cells with rounded, blue, lamellar cytoplasm resembling "onion skin" or "crumpled tissue paper"</figcaption></figure>

**Authors' contributions**

Photography: Dr Gurpreet Kaur. Write up: Dr Gurpreet Kaur, Dr Ankur Ahuja.

Proof reading: Dr Ganesh Kumar Vishwananthan, Dr Arijit Sen.

<figure><img src="image_3.png" /></figure>

<footnote>*Correspondence:
Gurpreet Kaur
gurpreet.sagoo37@gmail.com
¹Department of Hematology, All India Institute of Medical Sciences,
Ansari Nagar East, New Delhi 110049, India</footnote>
**Declarations**

**Ethics approval and consent to participate**

No ethics approval is required.

**Competing interests**

The authors declare that they have no competing interests.

Received: 13 July 2023 Accepted: 15 January 2024

Published online: 28 February 2024

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