This is an example of a mix of homogeneous and speckled ANA patterns.
In this sample notice the Speckled ANA is the dominant pattern in the interphase cells (a), and speckling is also seen outside of the chromosomal area of the mitotics (b).
Also notice the smooth staining of the chromosomal area of the metaphase mitotic cells (c). This represents the presence of a homogeneous ANA pattern.
In cases of mixed homogeneous and speckled ANAs, follow-up testing for anti-dsDNA and anti-ENA antibodies is necessary.
When mixed patterns are titered, the endpoint for each pattern is reported.
This pattern is reported as "ANA positive, Homogeneous and Speckled; titering is necessary."