Benign Heme, Somatic hematologic mutations, Heme Ditzels Flashcards
What’s going on with these neutrophils?
Traumatic morphologic changes that can sometimes occur with automatic wedge smear preparation
They are particularly prominent on PMNs, but you can confirm that this is what is going on by identifying the artifact in lymphocytes too.
What’s going on with this neutrophil?
The dreaded blue-green crystal of death
Quite rare - you may see 2-5 cases per year on hemepath services at a busy hospital.
Etiology still unclear, but highly associated with mortality within the next 2 weeks, approximately 70% chance. Usually you see these in patients with very severe disease that are in the ICU.
They are also refractile, unlike Dohle bodies, which can help you confirm the diagnosis.
What’s going on with these red cells?
These red cells are being partially obscured by clumps of precipitated cryoglobulin.
Sometimes they can also look like vacuolar inclusions in PMNs, due to receptor-mediated endocytosis of cryoglobulion immune complexes.
This is actually even easier to see on naked eye view of the slide. You can confirm the diagnosis by repeating the smear after warming the blood up to room temperature.
