Peripheral Blood Smear Examinationfamilymed.sbmu.ac.ir/uploads/hematology dr momtazmanesh.pdf ·...

Peripheral Blood Smear

Examination

Momtazmanesh MD.

Ped. Hematologist & Oncologist

Loghman General Hospital

Peripheral

Blood Smear

• A peripheral blood smear is a snapshot of the cells that

are present in the blood at the time that the sample is

obtained.

Momtazmanesh M.D.

When to Get Tested?

• When CBC results are abnormal. (flags)

• When a deficiency, disease, or disorder that can affect

blood cell production is suspected.

• As a quality control tool for the results of CBCs.

Momtazmanesh M.D.

Blood Smear prepration and staining:

1-Within 3 hours

2-Tradition wedge smear

3-Romanowsky stain (usually

Wright's, Giemsa)

Momtazmanesh M.D.

Momtazm

Making and Staining a Blood Smear

• Place a drop of blood approximately 4 mm in diameter on

the slide (near the end)

• Spread the drop by using another slide (called here the

“spreader”)

• placing the spreader at a 45° angle and BACKING into

the drop of blood.

• To make a short smear, hold the spreader at a steeper

angle, and to make a longer smear, hold it closer to the

• Prevent blood from reaching the extreme edges of the

slide.

• A smear with wavy lines or blanks spots should be

discarded, and a new smear made.

Evaluation of Blood Cells

•Selection of a suitable area

•Traditional sequence:

White cells

Red cells

Platelets

Parasites

Momtazmanesh M.D.

Evaluation of White Blood Cells

Total counts

Diff. counts

I:T ratio

Abnormal WBCs

Momtazmanesh M.D.

Pelger Huet

Momtazmanesh M.D.

Red Blood Cells

• Size

• Color

• Shape

• Arrangement

• Inclusions

• Young RBCs

Momtazmanesh M.D.

Hypochromia & microcytosis

• Iron deficiency anemia

• Thalassemia, α or β

• Sideroblastic anemia

• Chronic disease

• Infection

• Inflammation

• Cancer

• Lead toxicity

• Hemoglobin E trait

Macrocytosis

• Normal newborn

• Megaloblastic anemias

• Post-splenectomy

• Liver disease

• Hereditary aplastic anemia

• Hypothyroidism

Momtazmanesh M.D.

Target cells

• Thalassemic syndromes

• Hb C, SC, S-Thal, E, D

• Obstructive liver disease

• Postsplenectomy or hyposplenic states

• Severe iron deficiency

• LCAT (lecithin/cholesterol acyltransferase)

deficiency: (corneal opacifications, proteinuria,

target cells, moderately severe anemia)

• Abetalipoproteinemia

Momtazmanesh M.D.

Spherocytes

• Hereditary spherocytosis

• ABO incompatibility

• Autoimmune hemolytic anemia

• Burns

• Posttransfusion

• G-6-PD Deficiency

• Microangiopathic hemolytic anemia (MAHA)

• SS disease

• Hypersplenism

• Pyruvate kinase deficiency

• Water-dilution hemolysis

Momtazmanesh M.D.

Acanthocytes (spur cells)

• Liver disease

• DIC and other MAHA

• Postsplenectomy or hyposplenic state

• Vitamin E deficiency

• Hypothyroidism

• Abetalipoproteinemia: (fat malabsorption, retinitis

pigmentosa, neurologic abnormalities)

• Malabsorptive states

Momtazmanesh M.D.

Echinocytes (burr cells)

• Artifact

• Uremia

• Dehydration

• Liver disease

• Pyruvate kinase deficiency

• Peptic ulcer disease or gastric carcinoma

• Immediately after red cell transfusion

• Rare congenital anemias due to decreased

intracellular potassium

Momtazmanesh M.D.

Schistocytes • Helmet, triangular shapes, or small fragments

• DIC & MAHA (HUS, TTP)

• Severe hemolytic anemia (e.g., G6PD deficiency)

• Prosthetic cardiac valve, abnormal cardiac valve, cardiac

patch, coarctation of the aorta

• Connective tissue disorder (e.g., SLE)

• Kasabach–Merritt syndrome

• Purpura fulminans

• Renal vein thrombosis

• Homograft rejection

• Uremia, acute tubular necrosis, glomerulonephritis

• Malignant hypertension

Momtazmanesh M.D.

Elliptocytes

• Hereditary elliptocytosis

• Iron deficiency (increased with severity, hypochromic)

• SS disease & SA trait

• Thalassemia major

• Severe bacterial infection

• Leukoerythroblastic reaction

• Any anemia may occasionally present with up to 10%

elliptocytes

• Malaria

Momtazmanesh M.D.

Teardrop cells

• Newborn

• Thalassemia major

• Leukoerythroblastic reaction

• Myeloproliferative syndromes

Momtazmanesh M.D.

Stomatocytes

• Normal (in small numbers)

• Hereditary stomatocytosis

• Artifact

• Thalassemia

• Acute alcoholism

• Rh null disease (absence of Rh complex)

• Liver disease

• Malignancies

Blister cells

• G6PD deficiency (during hemolytic episode)

• SS disease

• Pulmonary emboli

Momtazmanesh M.D.

Basophilic stippling

• Hemolytic anemias (e.g., thalassemia trait)

• Iron-deficiency anemia

• Lead poisoning

Cabot’s Ring bodies

• Pernicious anemia

• Lead toxicity

Momtazmanesh M.D.

Howell–Jolly bodies

• Postsplenectomy or hyposplenia

• Newborn

• Dyserythropoietic anemias

• A variety of types of anemias (rarely iron-deficiency

anemia, hereditary spherocytosis)

Momtazmanesh M.D.

Heinz bodies

• G6PD Deficiency

• Normal in newborn

• Thalassemia (alpha)

• Asplenia

• Chronic liver disease

• Heinz body hemolytic anemia

Momtazmanesh M.D.

Nucleated red blood cells

• Not normal in the peripheral blood beyond the first week

of life

• Newborn (first 3–4 days)

• Intense bone marrow stimulation

• Hypoxia (especially postcardiac arrest)

• Acute bleeding

• Severe hemolytic anemia (e.g., thalassemia, SS

hemoglobinopathy)

• Congenital infections (e.g., sepsis, congenital syphilis,

CMV, rubella)

Momtazmanesh M.D.

Leukoerythroblastic reaction

• extramedullary hematopoiesis and bone marrow

replacement; most commonly:

• Leukemia

• Solid tumor

• Fungal and mycobacterial infection

Momtazmanesh M.D.

Platelet

Normal & Abnormal

Momtazmanesh M.D.

Bernard-Soulier Syn.

Grey Platelet Syndrome

Momtazmanesh M.D.

Bone Marrow Aspiration

Momtazmanesh M.D.

Normal Bone Marrow

Momtazmanesh M.D.

BMA in ITP

Momtazmanesh M.D.

myeloblast

Momtazmanesh M.D.

Bernard-Soulier Syn.

Momtazmanesh M.D.

Peripheral Blood Smear Examinationfamilymed.sbmu.ac.ir/uploads/hematology dr momtazmanesh.pdf ·...

Documents

Transcript of Peripheral Blood Smear Examinationfamilymed.sbmu.ac.ir/uploads/hematology dr momtazmanesh.pdf ·...

Examination of Peripheral Blood Smear Dr S Homathy 1.

11/20/2015 Normal Blood and Bone Marrow … is MDS.pdf · •One of the most common hematological malignancies “Blood cancers”. ... •Peripheral Blood smear ... Good Intermediate

Pathology Review of Peripheral Smear

Blood Smear interpretation

Examination of Peripheral Blood Smear - دانشکده پیراپزشکی ... · PPT file · Web view · 2012-12-22Peripheral Blood Smear. Objective. 1. Specimen Collection. 2. Peripheral

Peripheral Smear

05 peripheral blood smear examination

PALM Protocols - DNA HandlingPALM PProotocols -- DDNAN ... · PALM Protocols - DNA Handling 11 Blood and tissue smear Distribute a drop of (peripheral) blood or material of a smear

Using peripheral blood smear review to triage for … · neoplasms: • Distinguish ... Neff JL et al., Surgical Pathology 2013; 6:631639- ©2017 MFMER ... Using peripheral blood

CORRELATION OF PERIPHERAL BLOOD FILM, RED CELL INDICES ...repository-tnmgrmu.ac.in/1242/1/2003005muraliprasathsr.pdf · hypochromic anemia, identified in the peripheral smear report

Peripheral Smear Basics (Part 1) - HemePathRevie · 2005. 11. 16. · Pathologic Red Blood Cells in Peripheral Blood Smears Type of Cell Underlying Change Disease States Acanthocyte

RBC Morphology and Cases Dr. Gilberts Lab. CASE 1 Normal peripheral blood smear –A normal complete blood count (CBC) and normal peripheral blood smear.

Blood Smear

PERIPHERAL BLOOD SMEAR. introduction A properly prepared blood smear is essential to accurate assessment of cellular morphology The wedge smear is the.

Indication of peripheral blood smear-Pheripheral Smear Examination.pdf · Indication of peripheral blood smear exmination: 1. For carried out differential WBC count. 2. For differential

Blood smear morphology

Peripheral Blood Smear

1 Blood Smear

Blood Smear. This peripheral blood smear from a patient with essential thrombocythemia shows increased numbers of platelets, including some large.

LABORATORY DIAGNOSIS PERIPHERAL BLOOD SMEAR. A properly prepared blood smear is essential to accurate assessment of cellular morphology The wedge smear.