23 December 2020 (Wednesday) - e-HEMATimage case study

A couple of weeks ago a colleague and I looked at e-HEMATimage case study 20.03, but having technical issues we had to give up.
Seeing that we’d got access to the answers today I had a look…

Well, what can I say?... two of us looked, and two of us got the diff wrong. Many of what we thought were neutrophils were actually eosinophils.
Poorly stained eosinophils at that.

I suppose in retrospect there was something "iffy" about them - many of what were supposedly eosinophils I'd labelled as dysplatic neutrophils. But having missed the eosinophilia we plumped for a diagnosis of Myelodysplastic/myeloproliferative neoplasm (unclassifiable) rather than the consensus opinions of

1. Myeloid/lymphoid neoplasms with eosinophilia and gene rearrangement (PDGFRA, PDGFRB, FGFR1 or PCM1-JAK2)

2. Chronic eosinophilic leukemia (WHO)

3. Acute myeloid leukemia with multilineage dysplasia (WHO)

For me the take-home message is look for shape in eosinophils, not just the colour. I've learned something here...

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