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…

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