12 July 2022 (Tuesday) - NEQAS 2203DM

A month ago I had another digital morphology case...
"An acutely unwell patient in the emergency department. You are told that the analyser reports a mild anaemia and thrombocytosis, and has been flagged as abnormal – no other information is available. You are asked to interpret the film".

What a load of rubbish. Far more information would be available including cell counts and clinical information. Again we are given one microscope field from which we could guess (and I mean "guess") absolutely anything.

 Looking at the image I saw

Red cell fragments

Very occasional echinocytes

Thrombocytosis with large platelets and agranular platelets



Reactive lymphocytes with some (one!) cytoplasmic blebbing

Now I’ve forgotten all about it the results became available. It turned out to be “A case of burns: The key features here is the extensive microspherocyte formation accompanied by budding of red cells (https://haematologyetc.co.uk). This reflects an unstable cytoskeleton caused by heating – in this case burns, causing red cells to lose both membrane and cell contents. The residual cell becomes a microspherocyte while the active budding and small red cell fragments show the acute nature of the damage. For a discussion of this and other possible causes see: (https://.haematologyetc.co.uk/microspherocytes). Note also the activated white cells reflecting inflammation and the echinocytes reflecting the electrolyte disturbance typical of burns”.

I spotted all the salient features… I’m chalking that one up as correct.

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