In which type of neoplasia would you most likely observe smudged WBCs?

In chronic lymphocytic leukemia (CLL), one hallmark finding in peripheral blood smears is the presence of smudged or "smudge" cells. These cells are mature lymphocytes that have fragile membranes, leading them to rupture during the preparation of blood smears. This phenomenon occurs due to the high lymphocyte count commonly seen in CLL, which overwhelms the slide preparation process and results in cell smudging.

Chronic lymphocytic leukemia is characterized by a proliferation of small, mature appearing lymphocytes that can accumulate in the blood, bone marrow, and lymphoid organs. As the disease progresses, the fragile nature of these cells contributes significantly to the formation of smudge cells. In contrast, other forms of neoplasia, such as multiple myeloma, acute lymphocytic leukemia, or Hodgkin's lymphoma, do not typically produce this specific finding in blood smears. Each of these conditions presents with different hematological abnormalities and cellular characteristics, making the presence of smudge cells strongly indicative of CLL.