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Clincal pearls for peripheral smear reading

Discussion in 'Pathology' started by Gastrin, Jul 7, 2017.

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  1. Gastrin

    Gastrin 5+ Year Member

    35
    0
    Mar 13, 2012
    Hi guys,

    I am a new hematology/oncology fellow. I am just learning to review path smears. I would appreciate some clinical pearls and suggestions for resources.

    e.g. I'm having trouble differentiating the different precursor white cells.

    I will start with a few I know of

    - >3 schistos/HPF is concerning
    - avf no of platelets per HPF x20 = roughly the platelet count
    - features of BM dysplasia: neutrophils w bilobed nuclei or hyperlobulated nuclei, pale granules in granulocytes
    - it's easy to find WBCs at the top or bottom edge of the smear

    Any suggestions would be appreciated.
     
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  3. Mace1370

    Mace1370 10+ Year Member

    702
    45
    Jul 8, 2007
    Physician
    Army
    For differentiating the different precursor white cells, try to get an atlas that has pictures of each stage (there are a bunch). Review that so that you know what you are supposed to be looking for. You can then sit with a pathologist or a tech (many are good at the identification of white cells) to practice.
     
  4. univlad

    univlad Member 10+ Year Member

    195
    16
    Jul 14, 2002
    Yes. Sit down with one of the techs who counts marrows in the lab. They are best since they count a lot of marrows per day. Otherwise, the hemepath fellow or attending would likely be willing to sit down with you.
     
  5. yaah

    yaah Boring SDN Administrator 10+ Year Member


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