9 March 2025 (Sunday) - Slide Saturday Challenge

The nice people at the American Society of Hematology did another Slide Saturday Challenge. It’s a sickle cell.

But I’m not at all keen with their comment “did you guess correctly?”. This rather implies that they were expecting answers of target cell, keratocyte, blister cell, polychromasia, basophil, and pretty much everything you might find in the index of an atlas of haematology. To my mind there are two acceptable answers here.

• Sickle cell (or posh terms for the same)
• Don’t know

Perhps I’m being pedantic, but we really shouldn’t be encouraging people to guess. Perhaps the comment might be phrased differently in future.

Perhaps I should have commented on the original Facebook post?

 

5 March 2025 (Wednesday) - Atypical Lymphocytes

The nice people at the American Society of Hematology sent me this article today. A review of atypical lymphocytes.

If there’s one thing I see all the time it is atypical lymphocytes. On reflection I describe them by waving my hands in the air and using swear words. This article rather consolidates what I know and gives it some formal grounding.

Feature	Reactive	Malignant
Patient’s age	<30	>50
Lymphadenopathy	Typically absent	May be present
Absolute lymphocyte count	Usually increased	Increased, normal, or decreased
Percent lymphocytes	Usually increased	Increased, normal, or decreased
Platelets	Normal	Normal or decreased
Anemia	Absent or mild	Usually present
Cell heterogeneity	Present	Absent
Cell size	Variable but usually large	Small to medium to large
Nucleus	Irregular	Round, indented, folded, irregular
Nucleolus	Absent or inconspicuous	Absent, prominent
Cytoplasm	Abundant, radiating basophilia	Scant to moderate
Cytoplasmic projections	Absent	May be present *
Red blood cell molding	Present	Usually absent
Smudge cells	Absent	May be present **

 

4 March 2025 (Tuesday) - Fritsma Factor Newsletter

The nice people at Fritsma Factor sent their update today. Factor deficiencies, lupus, standardization of INR results… all good stuff.

4 March 2025 (Tuesday) - BTLP-TACT Exercise

I’ve walked the dogs, given them a wash, had a cuppa and got a little time before the late shift. What else might I do…

 

I was presented with two cases:

08666 – a ninety-three year-old woman awaiting surgery needing group and save.

She grouped as A Rh(D) Negative with antibody screen positive in cells 1 and 3. I requested antibody panels.

The IAT panel was positive in cells 1, 3, 6, 9 and 10 corresponding with anti-Fy(a) but not excluding anti-Cw or anti-Lu(a). But the enzyme screen was negative throughout so this did exclude them

02480 – an eighty-two year-old chap in A&E with coffee ground vomit also needing group and save.

He grouped as A Rh(D) Positive with antibody screen positive in cell 2. I requested antibody panels. The IAT and enzyme panels were positive in cells 2 and 6 corresponding with anti-K

 

I got it right…

2 March 2025 (Sunday) - Slide Saturday Challenge

Tear drop cells. Myelofibrosis...  myelophthisic? Thta's a new word. I wonder what it means...

2 March 2025 (Sunday) - BTLP-TACT Exercise

I’ve got an hour before I’m off to the late shift. There’s not a lot else for me to do…

 

I was presented with a nine-year-old child having a liver transplant needing FFP and cryo.

 

He grouped as O Rh(D) Negative with a negative antibody screen.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2958698/ implies both FFP and cryo are indicated in liver transplants so I selected four units of FFP and two units of cryo as requested.

 

I got the thumbs-up.

28 February 2025 (Friday) - NEQAS 2501 PA

I got the results of the parasitology NEQAS exercise 2501 PA today.
 

• I didn’t see anything in sample 2501PA1 – there wasn’t anything in it.
• I saw P. vivax in sample 2501 PA2 – that was correct.

 
I’m seeing that as a result.