It is also important to distinguish blasts from large reactive lymphocytes, which can really mimic each other. Again, we use various findings, including clinical signs, hematologic results, cytologic features of the cells, to help make this determination (. everything is context- or case-dependent). In some cases, we cannot distinguish between “blasts” and reactive lymphocytes. In such cases, evaluation of the patient for evidence of cancer or serial monitoring of the patient will be needed to help with this distinction.