Sea blue histiocytes (SBH) may be identified in the bone marrow of patients with a variety of different conditions, especially when the marrow is hypercellular.


Features of the sea blue histiocytes:

(1) increased cytoplasm with coarse, basophilic granules

(2) small nucleus

(3) The granules stain with Sudan black and periodic acid Schiff (PAS) stains.


Conditions associated with sea blue histiocytes:

(1) Niemann Pick disease

(2) Hurler disease or other storage disorders

(3) chronic myelogenous leukemia or other chronic myeloproliferative disorder

(4) myelodysplasia (MDS)

(5) Hodgkin's disease

(6) multiple myeloma

(7) immune thrombocytopenic purpura (ITP)

(8) sickle cell anemia

(9) infectious mononucleosis

(10) dyslipidemia (hypercholesterolemia, hyperlipoproteinemia)


Differential diagnosis:

(1) pseudo-Gaucher cells

(2) mast cells

(3) iron stores


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