Blood films showing vacuolated lymphocytes

Photomicrographs of blood films submitted for examination for the presence of vacuolated lymphocytes.
(A) Routine May-Grunwald-Giemsa stained blood film showing two lymphocytes with many large bold vacuoles, such as are seen in GM1 gangliosidosis, and juvenile Batten disease.
(B) Routine May-Grunwald-Giemsa stained blood film showing a lymphocyte with discrete small vacuoles seen in Pompe disease and adult acid maltase deficiency.
(C) PAS stained blood film showing a lymphocyte with PAS positive inclusions in Pompe disease and adult acid maltase deficiency.
(D) Toluidine blue stained blood film showing metachromatic cytoplasmic inclusions in a lymphocyte.
(E) Enzyme histochemical demonstration of beta galactosidase in a blood film showing normal enzyme activity in a lymphocyte and eosinophil but negative activity in a neutrophil.
(F) Enzyme histochemical demonstration of beta galactosidase in a blood film showing absent enzyme activity in a lymphocyte and a granulocyte seen in GM1 gangliosidosis and galactosialidosis.