The spleen and lymph nodes
Michael Gaunt, Tjun Tang, Stewart Walsh in General Surgery Outpatient Decisions, 2018
Full blood count and blood film provide information on the number of blood cells circulating and the presence of abnormal cell types (as described above). Hypersplenism results in anaemia, leucopenia and/or thrombocytopenia.Hyposplenism results in abnormal red blood cells (Burr cells, target cells, pitted cells); red cell inclusions (Howell-Jolly bodies, siderotic granules); abnormal platelet morphology; thrombocytosis; and leucocytosis (neutrophilia, lymphocytosis, monocytosis).
Quality Control and Quality Assurance in Hematology
Harold R. Schumacher, William A. Rock, Sanford A. Stass in Handbook of Hematologic Pathology, 2019
Quality control techniques that are visual and not mathematical: Preparation of a thin blood film and its evaluation.Staining of a blood film and its evaluation.Overall microscopic evaluation of a blood film for diagnostic purposes.
Plasmodium spp.
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
The mainstay of diagnosis is by a blood film. Thick or thin films are prepared from finger-prick blood. These are stained with Giemsa or Fields stain and viewed under the microscope. The degree of parasitemia is noted and the morphological appearance of the trophozoite (or gametocyte) can be used to identify the species of malaria (see diagnostic stages in Figure 2).
Secondary erythrocytosis due to hemoglobin San Diego
Published in Baylor University Medical Center Proceedings, 2021
In December 2014, a 37-year-old Hispanic man with known mild asthma presented to a local physician with a hemoglobin of 19.4 g/dL, platelet count of 178 × 109/L, and white blood cell count of 6.5 × 109/L. He had fatigue and intermittent headaches. Physical examination was unremarkable. Blood film revealed normal cellular morphology. Serum chemistry, erythropoietin, and testosterone were normal. Janus Kinase-2 mutations (including exon 12 and 13) were negative (Table 1). A sleep study ruled out sleep apnea. A bone marrow biopsy revealed normocellular marrow with trilineage hematopoiesis only. A bone marrow cytogenetic study revealed 46, XY in all 20 metaphases. Abdominal ultrasound ruled out masses, cysts, or hepatosplenomegaly. The asthma appeared to be too mild to be the culprit for SE. He was diagnosed with SE of unknown etiology and underwent intermittent therapeutic phlebotomy until mid-2019.
How I approach new onset thrombocytopenia
Published in Platelets, 2020
Blood film examination is pivotal and careful attention should be directed to all cell lines. Recognition of schistocytes is critical for assessment and exclusion of MAHAs, such as TTP. Red cells should be examined for spherocytes and polychromasia, which would point to associated hemolysis (Evans syndrome). White cells should be examined for the presence of immature forms, which would suggest a hematological malignancy; or reactive lymphocytes, as seen in acute viral infections such as dengue or cytomegalovirus infection. Platelets should be inspected for number, size, and granularity. Platelet size, either estimated from blood film review or measured by the analyzer (reported as mean platelet volume (MPV)) can be useful to guide molecular analysis in suspected hereditary thrombocytopenia syndromes as these can be categorized according to expected platelet size (Table II).
The Importance of Characterizing the Hemoglobin Instability of New Variants: The Case of Hb Dompierre [β29(B11)Gly→Arg, HBB: c.88G>C]
Published in Hemoglobin, 2020
Etienne Mondesert, Muriel Giansily Blaizot, Olivier Tournilhac, Anne François Serre Sapin, Bernard Aubin, Jean-Luc Pellequer, Patricia Aguilar Martinez
At the time of the laboratory reassessments, slight thrombocytopenia (117.0 G/L) was the only anomaly of the CBC and differential observed. No increase in the reticulocyte count (96.0 G/L) was noted. The blood film showed the presence of a few spherocytes (3.0%). Hemoglobin studies confirmed the presence of an abnormal Hb fraction (40.0% on CE), which coeluted with Hb A2 on cation exchange HPLC, and migrated between Hb S (HBB: c.20A>T) and Hb F on IEF. This fraction was not separated from Hb A under acid pH electrophoresis. Hb A2 was slightly elevated (3.5%) on CE, which was also the case in the initial report [2]. Genetic tests identified the HBB: c.88G>C mutation previously described in HbVar [2] in the heterozygous state, and further analyses (search for mutations and large rearrangements) on the HBB, HBA1, and HBA2 genes were negative. No Hb precipitates were observed on the isopropanol test after 50 minutes of incubation and the test was, therefore, considered negative. However, an Hb precipitate was present after 24 hours in the patient’s test tube, whereas the control tube was devoid of any precipitates. This never occurs in normal samples. In addition, the search for Heinz bodies turned out to be positive after 4 hours of incubation at 37 °C, and became massively positive after 24 hours, with 98.0% of RBC showing multiple membrane inclusions [Figure 1(A–C)]. This behavior and pattern are typical of other known unstable Hbs previously diagnosed routinely at our laboratory.
Related Knowledge Centers
- Blood
- Microscope Slide
- Hematology
- Malaria
- Filariasis
- Fixation
- Methanol
- Staining
- Romanowsky Stain
- Wright'S Stain