HEMEPATH rotation advice

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Bugati

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Hi can anyone shed some light on what you really need to know before you start a hemepath rotation- classification, cell morphology and what else- and any good sources to refer to?? I will be starting one soon and it is a mixed- in a single day we could go from looking at everything including- LN, BM or flow etc.

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Hi can anyone shed some light on what you really need to know before you start a hemepath rotation- classification, cell morphology and what else- and any good sources to refer to?? I will be starting one soon and it is a mixed- in a single day we could go from looking at everything including- LN, BM or flow etc.
I started my hemepath rotation at the beginning of my second year with the level of hemepath knowledge close to Robbins. I've learned so much during it. I was lucky to have an excellent mentor who would spend three hours at the scope with me every day signing out cases, which I would have previewed by then. Obviously, the particularities of the learning process will depend on the setup of your rotation. Here's my piece of advise based on my experience.

Classifications - it's better if you have a general idea.

IHC/flow markers - again, have a general idea. Immature cells versus mature, myeloid versus lymphoid, B versus T, differential markers for small cell lymphomas - and you should have a good solid basis.

Cell morphology - in my opinion, this is something you can only learn at the scope. Before the rotation all the myeloid precursors used to look the same, if only a slightly different shade of purple to me. Seeing them under the scope and having someone to explain to you the subtle features was what put everything in place

Best resource to start with - the WHO 2008 book (for white blood at least). This was the first book I bought with my book fund money and I love it. The Eric Hsi book is good too, and it also has red blood and platelets in it. I would stick with one source for white blood though, otherwise it gets too confusing.

GL with your rotation
 
Having been a resident doing heme rotations at two different places, for me it seemed like it primarily depended on who was running the show. I.e., some are organized in such a way that you will be fed certain things and don't necessarily need to study outside resources, while other things you'll need to do more on your own. The thing about heme is that there can be a lot of subtleties involved and a lot of drilling down to more and more and more detail in the final diagnoses. But for the most part everything can also be approached in broad categories based on phenotype and a very few immunos. As a result I've always thought review books/notes on heme did a better job than most of the textbooks in teaching you how to approach the subject because they offer the big picture (X -does- have this and that but not the other), while some textbooks seem to want to show you how smart the authors are and end up potentially confusing something which in a lot of ways isn't that complicated (X -might- have this or that in a certain percentage of cases and not the other sometimes but mostly not..).
 
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Bumping this old thread to ask for advice. I'm starting residency with two blocks of hemepath (which I find intimidating since I won't even have the cushion of some clinical knowledge on the subject, unlike surg path. I mean, the closest you get in GS residency is hacking out a lymph node, dropping it in a specimen cup, and then reading the diagnosis on the final path report and thinking of euphemisms for "that sounds terrible.") I have the WHO 2008 book-- is that the best for a crash course?
 
Learn to walk before you learn to run.

The WHO Heme is great for upper level residents who are working on comprehensive knowledge of individual diagnostic entities and the subtleties that allow for distinction of difficult cases. I tell my residents on their first heme rotation that they should try and read a chapter per night from each volume of Kjeldsberg and watch TV with a blood cell morphology atlas.
 
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I agree with Z-N. Altho 2 volumes it is
Thank you. This one, right?

http://www.amazon.com/gp/aw/d/089189571X/ref=mp_s_a_1_1?qid=1402596012&sr=8-1

It's a big two-volume book- that's the best intro? Then use the WHO one whenever I do the rotation again as an upper-level?

I agree with Z-N. It is not a difficult read. Small pages, good size type and lots of "tables" and such. The 2 vol. format is based on one being neoplastic and the other being non-neoplastic.
The ASCP blood cell morphology atlas is pretty good.
 
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