Sample Question from White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions, presented by MediaLab

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

Atypical Cells: Quantitative Estimate

Smudge cells are indicated by the arrows in this image.
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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