Peripheral blood smear: Difference between revisions
→Red blood cells: +WBC |
m →White blood cells: Bolded |
||
| Line 28: | Line 28: | ||
Look for: | Look for: | ||
<gallery mode=packed> | <gallery mode=packed> | ||
File:Myeloblast with Auer rod.jpg|thumb|Blast cells, generally having large nucleus, immature chromatin, a prominent nucleolus, scant cytoplasm and few or no cytoplasmic granules. This example has an Auer rod (to the left of the nucleus). | File:Myeloblast with Auer rod.jpg|thumb|'''Blast cells''', generally having large nucleus, immature chromatin, a prominent nucleolus, scant cytoplasm and few or no cytoplasmic granules. This example has an Auer rod (to the left of the nucleus). | ||
File:Hypersegmented neutrophil.jpg|Hypersegmented neutrophil. This is abnormal when more than half of neutrophils have at least 4 segments, or more than 5% of neutrophils have more than 5 segments.<ref name="Glassy 1998 p. ">{{cite book | last=Glassy | first=Eric | title=Color atlas of hematology : an illustrated field guide based on proficiency testing | publisher=College of American Patholgists | publication-place=Northfield, Ill | year=1998 | isbn=978-0-930304-66-9 | oclc=40976106 | page=}}</ref> | File:Hypersegmented neutrophil.jpg|'''Hypersegmented neutrophil'''. This is abnormal when more than half of neutrophils have at least 4 segments, or more than 5% of neutrophils have more than 5 segments.<ref name="Glassy 1998 p. ">{{cite book | last=Glassy | first=Eric | title=Color atlas of hematology : an illustrated field guide based on proficiency testing | publisher=College of American Patholgists | publication-place=Northfield, Ill | year=1998 | isbn=978-0-930304-66-9 | oclc=40976106 | page=}}</ref> | ||
</gallery> | </gallery> | ||
{{Bottom}} | {{Bottom}} | ||
Revision as of 14:30, 11 November 2021
Author:
Mikael Häggström [note 1]
Look at and comment separately on white blood cells, red blood cells and platelets.
Red blood cells
| RDW in adults[1] | Terminology[1] |
|---|---|
| 14.5% - 18% | Mild anisocytosis |
| 18% - 26% | Moderate anisocytosis |
| > 26% | Severe anisocytosis |
When available automatic quantification of mean corpuscular volume (MCV) and red blood cell distribution width (RDW), usually as part of CBC panel, generally decides whether you will call the sample "normocytic" versus "microcytic"/"macrocytic" and/or "anisocytotic", even if it is not clearly visible in the microscope. If automated values are not available, compare RBC sizes to lymphocyte nuclei, which should normally be the same size.
Schistocytes (fragmented parts red blood cells) only needs mentioning if constituting over 1% of red blood cells.
Platelets
If CBC is performed, use count to determine whether platelets are "normal in number" or whether there is "thrombocytopenia" or "thrombocytosis". If no CBC, count platelets within a high power oil immersed field, which should normally be 8 to 20.
In thrombocytopenia from automatic counting, look in particular for clumping of platelets (which can cause a falsely low automatic platelet count). If present, check with the lab if it was sent in EDTA (which may cause artefactual clumping) and ask to have a blood sample sent in sodium citrate instead.
White blood cells
Look for:
-
Blast cells, generally having large nucleus, immature chromatin, a prominent nucleolus, scant cytoplasm and few or no cytoplasmic granules. This example has an Auer rod (to the left of the nucleus).
-
Hypersegmented neutrophil. This is abnormal when more than half of neutrophils have at least 4 segments, or more than 5% of neutrophils have more than 5 segments.[2]
![Hypersegmented neutrophil. This is abnormal when more than half of neutrophils have at least 4 segments, or more than 5% of neutrophils have more than 5 segments.[2]](/index.php?title=Special:Upload&wpDestFile=Hypersegmented_neutrophil.jpg){kind=link}
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
Image sources