White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions

Continuing Education Credits

• P.A.C.E.® Contact Hours: 2 hour(s)
• Florida Board of Clinical Laboratory Science CE Credit Hours -
  General (Hematology): 2 hour(s)

Objectives

• Recognize several peripheral white cell abnormalities and list the criteria necessary to request a morphological/clinical review.
• Recognize and list the criteria by which a leukemoid reaction is differentiated from leukocytosis with a left shift.
• Describe various intracellular white blood cell inclusions and correlate them with the metabolic, genetic, and reactive conditions with which they are associated.
• Estimate platelet counts from peripheral blood smear scans and discuss erroneous automated platelet results.

Course Outline

• White Blood Cell Disorders and Platelets
• Peripheral Smear Review Introduction
• Peripheral Blood Smear Preparation
• Evaluation Criteria: White Blood Cells and Platelets
• Criteria for Performing a Manual Review of the Smear
• Which of the images below represents an area of appropriate cell density to choose for performance of a manual differential?
• Platelet Estimates
• An automated platelet count of 40.0 X 109/L was reported. Review of the peripheral blood smear (see image to the right) reveals single platelets in op...
• Additional Comments
• Leukemoid Reaction and Toxic Changes
• Leukemoid Reaction
• Toxic Changes
• Thrombocytosis Associated with Toxic Granulation
• Case Study One
• The neutrophils illustrated in this image are representative of those seen in a female patient's peripheral blood smear. The total WBC was 28.5 X 109/...
• Toxic granulation noted in the neutrophils' cytoplasm reflects an increase in activity of which of the following? (Choose all that apply)
• A peripheral blood smear with many myeloid cells was presented for morphology review (see image on the right). Toxic granulation and vacuoles in the n...
• The association of increased platelets accompanying neutrophilia and toxic granulation, as illustrated in this image, is called thrombocytopenia.
• White Cell Nuclear and Cytoplasmic Abnormalities Related to Inherited Conditions
• Pelger-Huet Anomaly
• Chediak-Higashi Anomaly
• Alder Anomaly
• May-Hegglin Anomaly
• The inclusions noted in the cytoplasm of this white blood cell are most suggestive of which of these conditions?
• WBC inclusions: Summary
• Familial disorders: summary
• Case Study Two:The patient is a 10 year-old boy from Florida who developed abdominal pain while on a skiing trip with his family in Colorado. He was b...
• Case Study Two: Follow-up
• The cell indicated by the arrow in the image on the right is most consistent with Chediak-Higashi anomaly.
• Miscellaneous Granulocytic Cells
• Eosinophils
• Basophils
• A peripheral blood smear was reviewed and a representative field is shown on the right. Which of the following conditions may produce the results seen...
• Which of the following conditions is NOT associated with an increase in the white blood cell shown in the image on the right?
• Non Granulocytic White Blood Cells
• Disorders and Diseases Associated With Increased Monocytes
• Case Study Three
• Case Study Four
• Case Study Five
• Multiple Myeloma
• Smudge Cells
• Platelets
• Giant Platelets
• Thrombocytopenia
• Pseudo-thrombocytopenia
• Thrombocytosis
• Platelet satellites (see image to the right) may account for low platelet counts as determined by automated hematology cell counters. Satellitosis is ...
• The image on the right is a microscopic field from a Wright-Giemsa stained peripheral blood smear (1000X magnification). The structure indicated by th...
• A representative field from a peripheral blood smear, seen on the right, was held for morphological and clinical review as the total platelet count wa...
• The peripheral blood smear shown in this image was held for review because of an increased platelet count. Conditions in which platelets are increased...
• This image is representative of a peripheral blood smear. As a result of this phenomenon, some automated hematology analyzers may report:
• References
• References

Additional Information

Level of instruction: Intermediate

Intended Audience: Medical laboratory professionals, clinical laboratory science students and instructors of hematology.

General Information: This program provides several outstanding interactive case studies, which cover pertinent topics in white cell and platelet disorders. Numerous excellent photomicrographs enhance the text, and interactive questions help the student master the material.

Author Credentials: C. William Reiquam, MD (1923-2015) was a clinical professor of pathology in the School of Medicine, University of Colorado. One of his areas of expertise was hematology.