The American Society of Hematology sent
out their “Slide Saturday Challenge” yesterday. There’s a hypersegmented
neutrophil and macrocytosis. There’s also anisopoikilocytosis and tear drop
cells seen.
My gut feeling is that this is a case of
megaloblastic anaemia caused by a deficiency of vitamin B12 or folate.
But…
If that were the case wouldn’t there be
Howell-Jolly bodies? Was it a case of myelodysplasia? In the end I thought that
a case of myelodysplasia wouldn’t have that neutrophil and I went for megaloblastic
anaemia.
I was right to do so.
For all that this is Slide Saturday
Challenge I shall continue posting this on Sunday once the proper answer has
come up. As I have said before, on-line morphology does tend to attract those
who really haven’t got a clue. No matter what the case presented answers
usually range from piles through to dead for three weeks, and the more clueless
and wrong the suggestion, the more aggressively it is posted.
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