Peripheral blood smear: Difference between revisions
Jump to navigation
Jump to search
→White blood cells: +Monoblast and monocyte |
Report |
||
| Line 4: | Line 4: | ||
}} | }} | ||
Look at and comment separately on white blood cells, red blood cells and platelets. You generally don't need to aim for a perfect report, because for most purposes, a peripheral smear is a relatively simple screening test, and clinicians may opt to perform for example flow cytometry and/or a bone marrow biopsy if they want a better evaluation. | Look at and comment separately on white blood cells, red blood cells and platelets. You generally don't need to aim for a perfect report, because for most purposes, a peripheral smear is a relatively simple screening test, and clinicians may opt to perform for example flow cytometry and/or a bone marrow biopsy if they want a better evaluation. | ||
{{Comprehensiveness}} | {{Comprehensiveness|otherlegend=yes}} | ||
==Oil immersion microscopy== | ==Oil immersion microscopy== | ||
This is preferred for light microscopy of peripheral blood smears in order to achieve a very high magnification. First use low or medium power to center on suspicious cells, or where red or white blood cells are best appreciated. Put a drop of immersion oil on the location and switch to the immersion objective. Then, whenever there's oil on a slide, always think twice before switching between objectives so as to avoid getting oil on any of your dry objectives (which is a bit tedious to clean off). | This is preferred for light microscopy of peripheral blood smears in order to achieve a very high magnification. First use low or medium power to center on suspicious cells, or where red or white blood cells are best appreciated. Put a drop of immersion oil on the location and switch to the immersion objective. Then, whenever there's oil on a slide, always think twice before switching between objectives so as to avoid getting oil on any of your dry objectives (which is a bit tedious to clean off). | ||
| Line 118: | Line 118: | ||
</gallery> | </gallery> | ||
When '''smudge cells''' constitute more than 10% of white blood cells, or in patients with CLL, a separate smear with a drop of serum albumin to every four or five drops of blood should be made to stabilize cell membranes.<ref>{{cite web|url=http://www.captodayonline.com/Archives/0610/0610_qa.html|website=CAP Today|author=Fredrick L. Kiechle}} June 2010</ref> A semi-quantification of different cell lines should then be made on the albumin slide, whereas white and red blood cell morphology should still be made on the original slide, since it is altered by albumin. | When '''smudge cells''' constitute more than 10% of white blood cells, or in patients with CLL, a separate smear with a drop of serum albumin to every four or five drops of blood should be made to stabilize cell membranes.<ref>{{cite web|url=http://www.captodayonline.com/Archives/0610/0610_qa.html|website=CAP Today|author=Fredrick L. Kiechle}} June 2010</ref> A semi-quantification of different cell lines should then be made on the albumin slide, whereas white and red blood cell morphology should still be made on the original slide, since it is altered by albumin. | ||
==Report== | |||
Example report: | |||
{|class=wikitable | |||
| Normochromic normocytic red blood cells. Red blood cells show <normal morphology / anisopoikilocytosis with occasional ___>. {{Comment-begin}}If thrombocytopenia, also add "Schistocytes are not significantly increased" if applicable.{{Comment-end}} | |||
{{Finding-begin}}Leukocytosis with neutrophilia / lymphocytosis.{{Finding-end}} White blood cells show no left shift or blasts. | |||
Platelets show no evidence of clumping, and show normal granularity. | |||
{{Moderate-begin}}Causes of the above findings include ___.{{Moderate-end}} | |||
|} | |||
{{Bottom}} | {{Bottom}} | ||