1 December 2020 (Tuesday) - NEQAS 2007 BF

 I got hold of the results of NEQAS 2007 BF today.

2007 BF1

 

I said: Anisopoikilocytosis with macrocytes and Howell Jolly bodies, echinocytes, target cells, some red cell fragments, polychromasia and nucleated red cells Lymphocytosis with LGL Hypersegmented neutrophila Some myelocytes Vacuolated monocytes

Top ten reported features NRBC Howell Jolly bodies Polychromasia Target cells Neutrophilia Pappenheimer bodies Echinocytes Thrombocytosis Acanthocytes Macrocytic platelets

 This was the blood film from a patient with inherited Pyruvate Kinase (PK) deficiency who had previously had a splenectomy. I think I did OK… what’s the difference between an acanthocyte and an echinocyte anyway?

2007 BF2

I said:   Lymphocytosis ?? Plasma cells Some smear cells Mild rouleaux

Top ten reported features   Lymphocytosis Smear/smudge cells Neutropenia Roleaux Cleft nuclei “Other Leucocyte” Atypical mononuclear cells Reversed neutrophil/lymphocyte ratio Reactive lymphocytes/Plasmacytoid lymp Hypochromic cells

 This was the blood film from a patient with T-cell large granular lymphocytic leukaemia. I think I spotted the salient features. I’d take issue with some of the specific wording. A lymphocytosis without mention of a neutrophilia automatically implies a reversed neutrophil/lymphocyte ratio. And what’s the difference between an atypical mononuclear cell and a a reactive lymphocyte? And are reactive lymphocytes the same as plasmacytoid ones?

 I did OK I think. But (as always) I would question the relevance of a blood film with no accompanying blood count data.