31 August 2022 (Wednesday) - BTLP-TACT Exercise

A quick BTLP-TACT exercise…
 
95322 – a forty-eight year-old man in A&E requiring group & save
 
He grouped as B Rh(D) Positive with a negative antibody screen
 
 
13289 – a ten year old lad requiring two units of blood for tomorrow
 
He too grouped as B Rh(D) Positive also with a negative antibody screen
I selected two units of B Rh(D) Positive blood
 
I got the green light…

30 August 2022 (Tuesday) - NEQAS 2205 BF

I looked at the NEQAS 2203PA films on 18 August 

 

2205 BF1 

 

I saw:

 

Blast cells

Nucleated red cells 

Plasma Cells

Neutrophilia 

Myelocytes 

Hypochromia 

 

?? CML 

 

Consensus View

 

Nucleated RBCs

Blast Cells

Plasma Cells

Myelocytes

Neutrophilia

Left Shift

Abnormal/Suspect Lymphocytes

Lymphocytosis

Reactive/Plasmacytoid Lymphocytes

Polychromatic Cells

 

“This film was from a patient know to have multiple myeloma (plasma cell myeloma), with progressive disease.

In addition to the plasma cell population, there was a leucoerythroblastic blood film with marked neutrophilia with toxic granulation. This is likely to be a neutrophilic leukaemoid reaction to myeloma, which has been shown in some patients to be due to secretion of granulocyte colony-stimulating factor by the neoplastic cells. It was reasonable to suspect sepsis but it is useful to know that a leukaemoid reaction in myeloma/plasma cell leukaemia can simulate infection or chronic neutrophilic leukaemia”.

 

Well…. I thought this was CML… clearly an understandable mistake and I’ve learned something.

 

 

2205 BF2 

 

I saw:

 

2205 BF2 

 

Blast cells

Monocytosis 

Neutrophilia with agranular/dysplastic neutrophils

Myelocytes 

Nucleated red cells 

Thrombocytopenia 

 

?? CMML 

 

Consensus View

 

Blast Cells

Thrombocytopenia

Monocytosis

Myelocytes

Nucleated RBCs

Neutrophilia

Promyelocytes

Promonocytes

Left Shift

Hypogranular/Agranular Neutrophils

A total of 225 participants favoured a diagnosis of CMML 

I’ll take that…

30 August 2022 (Tuesday) - NEQAS 2203 PA

I looked at the NEQAS 2203PA films on 18 August 

I saw:

2203 PA1 

P falciparum 7.5% parasitaemia

2203 PA2 

??? P malariae (I wasn’t convinced and f it were not EQA I would have asked a colleague for their opinion

 

Consensus View

2203 PA1 

P falciparum 9.4% parasitaemia

2203 PA2 

P malariae

Got that right…