The results of the on-line morphology survey 2004 DM became available today. I’d noted:
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Rbc
Anisopoikilocytosis Basophilic stippling echinocytes Nrbc Rouleaux Tear-drop cells
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Wbc
Blast cells with cytoplasmic blebs Cleft nuclei Left shifted neutrophils myelocytes Neutrophil vacuolation Smear cells Toxic granulation
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Platelets
Giant platelets Megakaryocyte fragment Micromegakaryocytes
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And as is always the way the software then announced that I had completed the exercise before I felt I had. But the final part of the expert comment had me feel I got it right:
“The abnormal platelets, megakaryocyte fragments and micromegakaryocytes, together with the other very abnormal maturing morphology of other lineages reflect the underlying myeloproliferative disorder, and strongly favour a myelofibrosis. In this case the circulating blast cells indicate a transformation of the myelofibrosis to an acute leukaemia, and the blast cells have the appearances of megakaryoblasts. This was confirmed by flow cytometry”
These on-line morphology exercises are useful… they would be far better with more user-friendly software. (or is it just me?)
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