20 February 2022 (Sunday) - Blood Films (and other dinosaurs)

Clare was talking about APL in her blog yesterday, but she made me think. She said “Recognising an acute leukaemia heavily depends on your ability to make the distinction between different textures, colours and shapes!” and this is true of all haematological morphology, not just diagnosing leukaemia.

So often when talking about a blood film with a trainee I don’t use technical terms, I just wave my hands in the air and use very untechnical language in much the same way that I was taught. I dare not repeat how stomatocytes and Sezary cells were first described to me.
It has often been said that blood film morphology is more of an art than a science. And that is in many ways true.
 

I’ve heard a worrying rumour that as there are fewer and fewer experienced morphologists, there are plans to centralise blood film reviewing to centralised laboratories… which will reduced the available experience even more.
Back in the day when examining bone marrow we would perform PAS stains and Sudan Black stains. Techniques which were very subjective and are now largely superceded by flow cytometry. I wonder if blood film morphology will go the same way?

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