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The in vitro demonstration of lupus erythematosus (LE) cell has less significance for the diagnosis of SLE in the current era of immunoassays. Although over the years, the spontaneous in vivo occurrence of LE cell in numerous body fluids as an initial presentation of SLE has been documented.

Initially discovered by Malcolm Hargraves in the bone marrow and peripheral blood, these cells have been since described in pleural, pericardial, synovial, peritoneal fluid.[1,2] They can also be present in the cerebrospinal fluid and in the skin.[3] These cells are either mononuclear cells, but more frequently neutrophils, that have engulfed denatured nuclear material of another cell. They appear as a homogenous-looking mass, known as hematoxylin body, that compresses the nucleus of the phagocyte to the periphery of the cell [4] 

SLE remains a challenging diagnosis in older people as only 12% to 18% of the cases occur after the age of 50 years. [5]. The presence of the LE cell can not only aid in the further workup of the patient but also suggest the involvement of a particular organ or body cavities by SLE. Serological tests and immunoassays should be used for confirmation of the cytological findings.

References: 

 1. Hargraves MM, Richmond H, Morton R. Presentation of two bone marrow elements; the ‘tart’ cell and ‘LE’ cell. Proc Staff Meet Mayo Clin 1948;23:25–8.

2. Schumacher HR, Jr, Howe HS. Synovial fluid cells in systemic lupus erythematosus: light and electron microscopic studies. Lupus 1995;4:353–64.

3. Nosanchuk JS, Kim CW. Lupus erythematosus cells in CSF. JAMA 1976;236:2883–

4. Holman H. Systemic lupus erythematosus. A review of certain recent developments in the study of this disease. J Pediatr 1960;56:109–19. 

5. D’Andréa  A, Peillet D, Serratrice C et al.Diagnosis of systemic lupus erythematosus by presence of Hargraves cells in eosinophilic pleural effusion. Medicine (Baltimore). 2018; 97(42): e12871