9 March 2022 (Wednesday) - NEQAS 2201 BF

The result of NEQAS 2201 BF became available today.

2201 BF1


I said





Vacuolated monocytes

Occasional echinocyte



I felt this was a reactive picture

Consensus (seen by)


Thrombocytosis  524

Neutrophilia  399

Hypersegmented Neutrophils 305

Rouleaux  288

Myelocytes  249

Large/Giant Platelets  117

Monocytosis  108

Platelet Anisocytosis  72

Left Shift  66

Blast Cells  47


Well… four of my top five comments were there. And as for the diagnosis:
This patient had a history of a treated community acquired pneumonia… The reactive blood picture in these circumstances…
No need for undue alarm here.


2201 BF2


I said



Blast cells


Sezary cells

Auer rods



I felt this was either a case of myelomonocytic leukaemia of or (possibly) Sezary syndrome


Consensus (seen by)


Thrombocytopenia  483

Blast Cells  480

Nucleated RBCs  348

Monocytosis  335

Promonocytes  270

Myelocytes  165

Promyelocytes  90

Neutropenia  46

Auer Rods  29

Cleft Nuclei  29


I’d spotted that which needed spotting. And as for the diagnosis:
The morphological diagnosis in this case is therefore acute monocytic leukaemia
Perhaps not spot-on, but close enough to know that I’d need to sound the alarm bells.


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