6 December 2022 (Tuesday) - NEQAS 2206 DM

Whilst I am very grateful that I get to take part in the NEQAS digital morphology scheme, it has to be said that it could be organised a whole lot better. For example the entire answer could be published on the very second the exercise closes, couldn’t it? Is there *really* any need to wait until everyone has forgotten all about it before telling us what we all missed? (Oh, I’m in a bad mood today, aren’t I… is my sulk relevant? Yes. We all have little episodes at work and regardless of what mood we are in, we need to get it right. Reflection in action!)
Anyway… ages ago I was presented with a photo of a blood film and was told

“A man of 78 attended the Haematology Outpatient Department. He had good health, but was developing an anaemia: Hb 109 g/L, WBC 5.4 x 10^9/L, Platelets 155 x 10^9/L. An abnormal blood film was noted, this image shows a representative area of film.” 

The note I made were:

Red cells  Anisopoikilocytoosis  Target cells  Howell Jolly bodies  Rbc fragments

Wbc  Neutropenia  Blast cells Hairy cells  Smear cells

Plts  Large plts

 

The answer was: “These features are of hairy cell leukaemia but with additional evidence of hyposplenism. In fact the patient had undergone splenectomy as treatment for hairy cell leukaemia in the 1980s when this was one of the preferred options, though it is not done nowadays”

I think it fair to say I got this right…