This is (supposed to be) a reflective diary by a (not very) anonymous biomedical scientist who works somewhere in the south of England. One day this diary may well be submitted to the Health and Care Professions Council as evidence of ongoing continual professional development....
I looked at the NEQAS 2203PA films on 18 August
2205 BF1
|
I saw:
Blast cells Nucleated red cells Plasma Cells Neutrophilia Myelocytes Hypochromia
?? CML
|
Consensus View
Nucleated RBCs Blast Cells Plasma Cells
Myelocytes Neutrophilia Left Shift Abnormal/Suspect Lymphocytes Lymphocytosis Reactive/Plasmacytoid Lymphocytes Polychromatic Cells |
“This film was from a patient know to have multiple myeloma (plasma cell myeloma), with progressive disease.
In addition to the plasma cell population, there was a leucoerythroblastic blood film with marked neutrophilia with toxic granulation. This is likely to be a neutrophilic leukaemoid reaction to myeloma, which has been shown in some patients to be due to secretion of granulocyte colony-stimulating factor by the neoplastic cells. It was reasonable to suspect sepsis but it is useful to know that a leukaemoid reaction in myeloma/plasma cell leukaemia can simulate infection or chronic neutrophilic leukaemia”.
Well…. I thought this was CML… clearly an understandable mistake and I’ve learned something.
2205 BF2
|
I saw:
2205 BF2
Blast cells Monocytosis Neutrophilia with agranular/dysplastic neutrophils Myelocytes Nucleated red cells Thrombocytopenia
?? CMML
|
Consensus View
Blast Cells Thrombocytopenia Monocytosis Myelocytes Nucleated RBCs Neutrophilia Promyelocytes Promonocytes Left Shift Hypogranular/Agranular Neutrophils |
“A total of 225 participants favoured a diagnosis of CMML”
I’ll take that…
I looked at the NEQAS 2203PA films on 18 August
|
I saw: 2203 PA1 P falciparum 7.5% parasitaemia 2203 PA2 ??? P malariae (I wasn’t convinced and f it were not EQA I would have asked a colleague for their opinion)
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Consensus View 2203 PA1 P falciparum 9.4% parasitaemia 2203 PA2 P malariae |
Got that right…
