You are performing complete blood cell counts on an automated analyzer. One of t

Question

You are performing complete blood cell counts on an automated analyzer. One of the patient samples is "flagged," indicating a possible instrument error or abnormal cell population in the sample. Previous samples on this patient have been run without problems, although the patient previously had quite low white blood cell (WBC) counts - less than 100 neutrophils and less than 500 total WBC/mL. As per laboratory protocol you review the Wright-stained blood film. On your manual differential count, you find that the monocyte count is slightly increased. You note the presence of immature cells of the granulocyte series, including occasional promyelocytes and myeloblasts. In addition, Dohle bodies, increased granulocyte granulation and hypersegmented neutrophils are present.

1. What common clinical conditions can lead to the immature myloid cells seen in this smear?

2. What should you do to help you interpret this sample

Explanation / Answer

1. Acute myeloid/ mylocytic leukaemia and Chronic myeloid leukaemia.

These are cancers of wbc, which occur in bone marrow, and stimulates prodution on more myeloid series. This increaee results in premutaure realse of them in blood which then shows in stained smears on microscopic examination.

2 . To interpret this sample find the diagnosis, Bone marrow aspiration cytology is performed. We puncture bone marrow by needle and take sample of it which is then studied. It can also confirm the diagnosis. And DNA can be studied for any abnormalities.

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