What features are typically seen in the peripheral blood smear of chronic lymphocytic leukemia (CLL)?

In the peripheral blood smear of chronic lymphocytic leukemia (CLL), the most characteristic finding is the presence of small lymphocytes, which appear mature in appearance but are dysfunctional due to the malignant process. These small lymphocytes are often accompanied by a high number of these cells that account for the increased white blood cell count typical of the disease.

The rupture of cell membranes can occasionally be seen, which may result from various factors related to the pathology of CLL, including the fragility of the cells and interactions with the microenvironment. However, the highlight remains on the prevalence of these small, mature lymphocytes, which can also manifest in such a way in a blood smear.

Unlike the other options, which describe features associated with more acute or different types of leukemias (for instance, myeloblasts and lymphoblasts indicate acute forms of leukemia rather than a chronic process), the finding of small lymphocytes aligns closely with the chronic nature of CLL and differentiates it from other hematologic malignancies.