White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions (Online Course)

C. William Reiquam, M. D., Elmer W. Koneman, M. D.

This collection of informative case studies covers current topics in white cell and platelet disorders. Topics include leukemoid reactions, leukocytosis, intracellular granules, intra-cytoplasmic inclusion bodies, platelet satellitism, and more. Excellent for continuing education for clinical laboratory science professionals.

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Continuing Education Credits

• P.A.C.E.® Contact Hours: 3 hour(s)
• Florida Board of Clinical Laboratory Science CE - General (Hematology): 3 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 link them with the metabolic, genetic, and reactive conditions with which they are associated.
• Estimate platelet counts from scan of the peripheral blood smear and explain why machine platelet counts may be fallacious.

Course Outline

Click on a link in the outline to view a sample page from this course.

• White Blood Cell Disorders and Platelets:
• Peripheral Smear Review Introduction
• Peripheral blood smear preparation
• Criteria for evaluation of white blood cells and platelets
• Criteria for requesting a hematologist's review of the smear.
• Lymphocytes displayed in the photograph most likely would be called atypical or reactive. A quantita
• Atypical Cells: Quantitative Estimate
• Assume that several other lymphocytes similar to the one in the center of the photograph are found o
• Platelet Estimate
• An electronic platelet count of 40,000/cumm was reported. Review of the peripheral blood smear(see
• Additional comments on this exercise
• 1. Leukemoid Reaction vs Toxic Changes
• The neutrophils illustrated in this photograph are representative of those seen in the smear. The total WBC was 28,500 cells/cumm. The appropriate rep...
• The association of increased platelets accompanying neutrophilia and toxic granululation as illustrated in this photograph is called thrombocythemia.
• Toxic granulation noted in the neutrophils' cytoplasm reflects an increase in activity of the: (more than one answer may be correct)
• Typical cells on a peripheral blood smear as photographed here were repeatedly encountered as the smear was reviewed. The peripheral white blood cell ...
• Leukemoid reaction revisited
• A peripheral blood smear with many myeloid cells (photograph) was presented for morphology review. Toxic vacuoles in the neutrophil and monocyte most ...
• 2. Leukocytosis Case Study
• A peripheral blood smear is submitted for morphology review. The patient is a 10 year-old boy with s
• Case Follow-up
• The neutrophils seen in two fields in the upper and lower photographs are representative of a majority of the left shift neutrophils found in this per...
• Pelger-Huet Anomaly
• 3. Atypical Intracellular Granules
• Atypical neutrophilic intra-cytoplasmic inclusions ,as noted in the photograph, are present in a per
• Chediac-Higashi anomaly
• Alder- Reilly Anomaly
• The inclusions noted in the cytoplasm of this band neutrophil are most suggestive of:
• WBC inclusions: summary
• Familial disorders: summary
• 4. Intra-cytoplasmic Inclusion Bodies
• The pale-staining cytoplasmic bodies marked by the arrow in the photograph may be seen in each of th
• Case History
• Doehle Bodies: Review
• The May -Hegglin anomaly
• The cytoplasmic inclusion illustrated at the tip of the blue arrow is characteristic of:
• Auer Rod
• The cell illustrated in the photograph is known as a faggot cell.
• 5. Miscellaneous Granulocytic Cells
• The peripheral blood smear presented here was submitted for morphological/clinical review. Conditio
• Eosinophilia Follow-Up
• Eosinophil description
• The granulated neutrophil shown in the photograph may be found in each of the following conditions e
• The neutrophil on the peripheral blood smear in this photograph is a mast cell.
• Basophils
• 6. Non Granulocytic White Blood Cells
• The large blue staining cells represented here in the photographs comprise 50% of the total white bl
• Case history
• Case History 2
• Approximately 10% of the circulating white cells were similar to the one seen in the photograph. The
• Multiple myeloma
• A peripheral smear was submitted for morphology/clinical because of the number of monocytes as captu
• The peripheral smear photographed here was submitted for morphologic/clinical examination.The predom
• More about lymphocytes, their impostors and varied faces
• 7. Platelets
• Platelet satellites (marked in the photograph) may account for low platelet counts as determined by electronic counters. Satellitosis is initiated by:
• The large platelet captured in the center of the photograph is indicative of disordered megakaryopoiesis.
• The peripheral blood smear noted in the photograph was held for morophological and clinical review as the total platelet count was 10,000/cumm. Condit...
• The peripheral blood smear tagged in the photograph was held for review because of too many platelet
• This image is representative of a peripheral blood smear.Some automated instruments may report this platelet count as:
• 8. Miscellaneous Smear Reviews
• The small club-shaped(drumstick)nuclear appendage attached to one lobe of a neutrophil (marked by th
• The cell photographed here is known as a MOTT cell. The condition in which these cells are associated is:
• The smudge cells pictured in the photograph may be found in each of the following situations except:
• The cell bulging with inclusions in the image on the right is most consistent with Chediak-Higashi anomaly.
• A most useful follow-up test to consider when faced with hypersegmented neutrophils and oval macrocy
• Erythrophagocytosis

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Additional Information

Level of instruction: Intermediate

Intended Audience: Students and instructors of hematology, medical technologists, clinical pathologists, and pathology residents.

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 M.D. is a clinical pathologist at University of Colorado Health Sciences in Denver, CO. He has extensive experience in hematology and is currently focusing on evidence-based medicine and its implication for medial care outcomes.

Elmer W.Koneman M.D. is Professor Emeritus, Department of Pathology, University of Colorado School of Medicine. Residing in Breckenridge,CO, Dr. Koneman is a Board Certified Pathologist, former full Professor of Pathology University of Colorado School of Medicine. He is author of numerous journal articles and books.

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