9 December 2022 (Friday) --NEQAS Morphology

A month ago I looked at the NEQAS morphology exercise and I said for my top five comments and diagnosis

2207 BF1 Polychromasia Nucleated red cells anisopoikilocytosis Macrocytosis target cells ??megaloblastic

2207 BF2 Red cell fragments Thrombocytopenia Giant platelets anisopoikilocytosis Target cells ??? TTP

 

The consensus was:

2207 BF1 Polychromatic Cells Nucleated RBCs Spherocytes Tear Drop Poikilocytes Macrocytes Pseudo-Pelger Cells Myelocytes Left Shift Other Leucocyte Comment Target Cells   Autoimmune haemolytic anaemia (IHA)... with  an  additional  component  either  of  B12/folate  deficiency,  drug/toxin  (including  alcohol)  exposure,  or dysplasia.

2207 BF2 Fragments/Schistocytes Thrombocytopenia Echinocytes/Crenated Cells Polychromatic Cells Target Cells Large/Giant Platelets Acanthocytes Poikilocytes Keratocytes/Bite Cells Spherocytes   TTP

Bearing in mind how little information we (I) was given, I’m reasonably pleased. I can’t help but feel that this isn’t a fair assessment… when I look at a proper blood film I take into account a lot more lab data and clinical information… The second case was one which had been in hospital for a week… I think that’s a tad unfair.