3 April 2018 (Tuesday) - Blood FIlm NEQAS

About a month ago I looked at the latest NEQAS blood films. Here’s what I thought were the five most salient features:

1802 BF1 Neutrophilia Myelocytes  NRBC anisopoikilocytosis target cells

1802 BF2 Blast cells neutropenia poikilocytosis microcytosis hypochromia

Here’s the consensus ten most salient features :

1802 BF1 Nucleated RBCs Myelocytes Neutrophilia Band form neutrophils/Left shift Thrombocytopenia Polychromatic cells Toxic granulation Promyelocytes Howell Jolly Bodies

1802 BF2 Blast cells Thrombocytopenia Poikilocytes Acanthocytes Tear drop poikilocytes Nucleated RBCs Elliptocytes Echinocytes/Crenated cells Pencil forms Band form neutrophils/Left shift 10 80

So… how did I do? BF1 was a case of severe liver disease with a leukaemoid reaction. Did no one else rate the importance of the target cells?

                

BF2 was a case of ALL; I spotted the blasts. But as for the rest… “poikilocytosis” is a blanket term which includes Acanthocytes, Tear drop poikilocytes, Elliptocytes, Echinocytes/Crenated cells and Pencil forms.

Interestingly the information provided after the event glossed over the microcytosis and hypochromia.

Again the exercise expressed disappointment at how few participants gave a diagnosis. Again I’d say that isn’t my role.

And again I’d question the value of this form of blood film competency assessment. The only information provided is the patient’s age, gender, Hb and Wbc. But when the result are provided, all sorts of other information is given.

At the very least we should be given all the blood count results…