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Appearance:

Neutrophils forming aggregates on a blood smear (most frequently seen on the edges) and monocytes may be seen within these aggregates. Less commonly aggregates may be comprised of lymphocytes..

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Images of agglutination:

• Agg.jpg

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• Agg2.jpg

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• Agg3.jpg

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An EDTA-dependent phenomenon seen in neutrophils (image 1) and occasionally in lymphocytes (image 2); aggregation most frequently affects platelets (image 3).

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Cause:

This occurs mainly in EDTA samples, if in doubt a smear can be made using a finger-prick sample or other anticoagulant.

Consider:

A rare phenomenon that occurs in vitro and has little clinical significance, although may cause falsely low counts on automated counters

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