9 March 2022 (Wednesday) - NEQAS 2201 DM

The result of NEQAS 2201 DM became available today.When I looked at the image (a month ago) I wrote:

The immediate feature is target cells.
There were also some anisopoikilocytosis and polychromasia with giant platelets and occasional nucleated red cells and what could have been red cell auto-agglutination or could have been artefactual. At the top of the film were two rather dubious white cells – were they blast cells ?

And were the neutrophils left-shifted?
I don’t think this was a haemoglobinopathy as there were no contracted cells. I’m going more toward liver disease…

The narrative said:

The morphological features include frequent target cells and irregularly contracted cells, with evidence of very active erythropoiesis and a packed marrow (tear drop forms, polychromasia and nucleated red cells). Together these features are typical of HbC or HbSC disease. Supporting evidence is the presence of haemoglobin crystals in some red cells, but this does not allow us to distinguish between the two disorders. In this case the poikilocytes with unusual projections would favour a diagnosis of HbSC disease (although such cells can be difficult to identify).

Well… I saw the target cells, but not the contracted cells. Reviewing the image there was one contracted cell, and a “splat” that might have been an HbC crystal, but I wasn’t convinced.

Didn’t really do too well on this one, did I?…

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