White Blood Cell Disorders and Platelets:: Peripheral Smear Review Introduction

Atypical Cells: Quantitative Estimate

  • A smudge cell is centered in the photograph.
  • In some laboratories, a semi-quantitative estimate of the number of smudge cells may be made; in others, a report of "smudge cells present" may suffice.
  • The point is that a language for reporting semi-quantitative estimates must be established for any atypical cells appearing in the peripheral blood smear.
  • This reporting scheme must be understood by the physician in order to maximize patient care outcomes through his/her decision making process.
  • For example, in the context of this exercise, does it make any difference to the physician if you report few or many smudge cells; or, is a report of smudge cells present sufficient?
  • The answer to this question applies not only to smudge cells, but to the reporting of any other atypical white cells as well.
  • An agreement must be reached between the hematology laboratory and clinical services as to how semi-quantitative estimates will impact the need for further testing in view of patient care outcomes.

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