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Clincal pearls for peripheral smear reading

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

  1. Gastrin

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    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

    Physician

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    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

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    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
    Administrator Physician

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