The results of the latest NEQAS morphology became
available to me today. I looked at the films a month ago and can’t really
remember much about them but:
1807 BF1
I said “Film
is poorly stained, but: Macrocytosis with target cells and Howell-Jolly bodies
and nucleated red cells. Also a mild lymphocytosis. Some look odd, but
is that the staining? Some neutrophils are right shifted, but not many.
Also platelet count is OK.
*Possibly*
megaloblastic, but more likely liver disease or haemoglobinopathy - clinical
details would have helped.. “
It *was*
a haemoglobinopathy…
1807 BF2
I said “Again
film is poorly stained, but: Fragmented, echinocytic and
spherocytic red cells with some Howell-Jolly bodies seen and some
nucleated red cells. Reduced platelet count.
?MAHA
and/or DIC”
It was a case of TTP – I’ll take that.
Again I don’t think these exercises are a fair
assessment. We are provided with minimal information and expected to come up
with a comprehensive diagnosis.
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