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Haematology Laboratory Exams 25 > Morphology > Flashcards

Morphology Flashcards

1
Q

What are the common features of Chronic Myeloid Leukemia (CML)?

A
  • BCR-ABL Positive
  • Leukocytosis
  • Neutrophils in different stages of maturation
  • Myeloid peak
  • Basophilia
  • Eosinophilia
  • Platelet anisocytosis

Normal to 1000 platelets.

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2
Q

What is the definition of Accelerated Phase (AP) in CML?

A

> 10% blasts or >20 basophils in blood

These factors indicate transformation to a more severe phase.

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3
Q

What are the key genetic features associated with CML?

A
  • 90-95% have t(9:22) resulting in the Ph chromosome
  • BCR gene on 22
  • ABL1 gene on 9
  • Abnormal fusion protein (P210, P230, P190)

These fusions enhance tyrosine kinase activation.

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4
Q

What are the phases of Myeloproliferative Neoplasms (MPN)?

A
  • Chronic
  • Accelerated
  • Blastic (blast crisis)

Each phase has distinct clinical and laboratory features.

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5
Q

What are the diagnostic criteria for Primary Myelofibrosis (PMF)?

A
  • Megakaryocyte proliferation + atypia with fibrosis OR
  • If no fibrosis, megakaryocyte changes with granulocytic proliferation and decreased erythropoiesis
  • Not meeting WHO criteria for other myeloid neoplasms
  • JAK2V617F or other clonal marker

Minor criteria include leukoerythroblastosis, increased LDH, and splenomegaly.

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6
Q

What is the clinical significance of megakaryocytes in PMF?

A

Megakaryocytes are the most atypical in PMF compared to other MPNs

Their morphology can indicate the severity of the disease.

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7
Q

What laboratory features are associated with Essential Thrombocythemia (ET)?

A
  • Thrombocytosis
  • Platelet anisocytosis with giant forms
  • WBC usually normal

Leukoerythroblastosis and teardrops are not seen.

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8
Q

What are the diagnostic criteria for Polycythemia Vera (PV)?

A
  • Hb >185 (M) or >165 (F)
  • JAK2V617F or similar
  • Hypercellular BM with panmyelosis
  • Low serum EPO

Endogenous erythroid colony formation in vitro is also a criterion.

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9
Q

What is the hallmark of Chronic Neutrophilic Leukemia?

A

Neutrophilia (WBC >25)

Intermediate myeloid usually <5%.

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10
Q

What are the clinical correlations of Chronic Eosinophilic Leukemia?

A
  • Constitutional symptoms
  • Muscle pains
  • Angioedema
  • Pruritis
  • Diarrhea

These may indicate organ damage.

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11
Q

What is the criteria for diagnosing Hypereosinophilic Syndrome (HES)?

A
  • Eosinophilia >1.5 x109/L for >6 months
  • No underlying/reactive cause
  • Exclusion of AML, MPN, MDS, SM
  • Organ damage from eosinophilia

HES indicates organ damage, while hypereosinophilia without damage is a different condition.

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12
Q

What are the features of Mastocytosis?

A
  • Multifocal clusters of mast cells
  • Marked reticulin fibrosis
  • Paratrabecular or perivascular infiltrate
  • Clinical correlation with rash and skin lesions

Serum tryptase is often elevated.

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13
Q

What are the common cytogenetic findings in MPN/MDS?

A
  • JAK2 mutations
  • MPL mutations
  • CALR mutations
  • BCR-ABL

These mutations help distinguish between different myeloid disorders.

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14
Q

What is the clinical correlation for Leukoerythroblastic features?

A

CML, PV, ET, PMF

These features indicate bone marrow infiltration.

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15
Q

What does the term ‘dysgranulopoiesis’ refer to?

A

Abnormal granulocyte formation

It is often seen in MPN/MDS.

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16
Q

What is the definition of mild to moderately increased reticulin fibrosis?

A

A condition characterized by increased reticulin fibers in the bone marrow.

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17
Q

What clinical correlations are associated with increased reticulin fibrosis?

A

B symptoms and hepatosplenomegaly.

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18
Q

What does IHC: CD34 indicate in the context of hematologic disorders?

A

The presence of CD34, a marker for hematopoietic progenitor cells.

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19
Q

Which myelomonocytic antigens are identified in flow cytometry?

A
  • CD13
  • CD33
  • Variable CD14
  • CD68
  • CD64
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20
Q

What cytogenetic abnormalities are commonly found?

A
  • +8
  • -7 del(7q)
  • 12p structural abnormalities
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21
Q

Which mutations should be looked for in a molecular analysis?

A
  • SRSF2
  • TET2
  • RAS/MAPK pathway mutations
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22
Q

What is the diagnostic criteria for persistent PB monocytosis?

A
  • Persistent PB monocytosis >1x10^9/L for > 3 months
  • No Ph chromosome or BCR-ABL
  • No PDGFRA/B
  • <20% blasts in PB and BM
  • Dysplasia in 1+ myeloid lineages
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23
Q

What defines CMML-1?

A

Blasts <5% in PB and <10% in BM.

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24
Q

What defines CMML-2?

A

Blasts 5-19% in PB, 10-19% in BM or presence of Auer rods.

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25
Q

What are the characteristics of atypical CML?

A
  • BCR-ABL Negative
  • Leukocytosis >13
  • Macroovalocytosis
  • Dysplastic neutrophils
  • Thrombocytopenia
  • Hypercellular bone marrow
  • Granulocytic proliferation
  • Dysgranulopoiesis
  • Dyserythropoiesis
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26
Q

What are the common cytogenetic findings in atypical CML?

A
  • +8
  • del(20q)
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27
Q

What is the diagnostic criteria for atypical CML?

A
  • Leukocytosis >13x10^9/L
  • No Ph/BCR-ABL, no PDGFRA/B
  • Neutrophil precursors >10% of leukocytes
  • Minimal basophilia and monocytosis
  • Hypercellular BM
  • <20% blasts in PB or BM
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28
Q

What are the myelodysplastic syndromes (MDS) classifications?

A
  • RCUD
  • RARS
  • RCMD
  • RAEB 1
  • RAEB-2
  • Del 5q
  • MDS unclassifiable
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29
Q

What are the diagnostic features of MDS?

A
  • Dysplasia
  • <20% blasts
  • Leukoerythroblastic
  • Cytopenias or pancytopenia
  • Trilineage dysplasia
  • Dyserythropoiesis
  • Dysgranulopoiesis
  • Dysmegakaryopoiesis
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30
Q

What clinical features are associated with MDS?

A
  • Hb <100
  • Neutrophils <1.8
  • Platelets <100
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31
Q

What are the prognostic factors in MDS?

A
  • % blasts in BM
  • Karyotype
  • Cytopenias
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32
Q

What are the karyotype classifications for prognosis in MDS?

A
  • Good: normal, -Y, del(5q), del(20q)
  • Poor: complex, chrom 7 abnormalities
  • Intermediate: other abnormalities
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33
Q

What are the key features of acute leukemia?

A

Lineage not clear, requires urgent referral and review.

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34
Q

What are the key components of acute leukemia diagnosis?

A
  • Bloods: coags, EUC, LDH
  • Bone marrow aspirate and trephine (BMAT)
  • Morphology
  • IHC: CD34/117/E-cad
  • Flow: lineage orientation tube
  • Cytogenetics + FISH
  • Molecular
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35
Q

What molecular mutations are significant in acute leukemia?

A
  • NPM1
  • CEBPA
  • FLT-3
  • Others: MLL, KIT, N/KRAS, WT1
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36
Q

What are the prognostic factors for acute myeloid leukemia (AML)?

A
  • Bi-allelic CEBPA
  • CEBPA + NPM1 (without FLT3)
  • FLT3-ITD, KIT (poor prognosis)
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37
Q

What is the characteristic feature of acute promyelocytic leukemia (APML)?

A

Faggot cells and bilobed blasts with intense granulation.

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38
Q

What is the significance of the 15:17 translocation in AML?

A

It indicates the presence of PML-RARA fusion gene.

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39
Q

What defines the prognosis of AML with balanced translocations?

A
  • Favourable: inv(16), t(8;21), t(15;17)
  • Intermediate: +8, t(6;9), t(9;11)
  • Unfavourable: -7, -5, del 7q
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40
Q

What does leukoerythroblastic mean?

A

The presence of immature white blood cells and nucleated red blood cells in the blood.

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41
Q

What are the characteristics of precursor lymphoid neoplasms?

A
  • B-ALL: Small blasts with scant cytoplasm
  • T-ALL: Often high WCC
  • Clinical correlation: lymphadenopathy, hepatosplenomegaly
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42
Q

What is the flow cytometry panel for B-ALL?

A
  • CD45
  • 19
  • CD10
  • 20
  • 38
  • 58
  • 9
  • 13+33
  • 34
  • 7
  • cyt79a
  • smCD3
  • cyt CD3
  • MPO
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43
Q

What is the significance of the t(9;22) translocation?

A

It is associated with a poor prognosis in B-ALL.

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44
Q

What are the markers for T-ALL in flow cytometry?

A
  • Tdt
  • CD1a
  • CD2
  • CD3
  • CD4
  • CD5
  • CD7
  • CD8
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45
Q

What is the relationship between eosinophilia and t(5;14)?

A

It is associated with an increase in circulating eosinophilia.

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46
Q

What are the characteristics of chronic lymphocytic leukemia (CLL)?

A
  • Lymphadenopathy
  • No cytopenias
  • Lymphocytes <5x10^9/L in PB
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47
Q

What are the flow cytometry markers for CLL?

A
  • CD5+
  • CD10-
  • CD19+
  • CD20/22+dim
  • CD23+
  • Light chain restriction
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48
Q

What are the prognostic factors in CLL?

A
  • LDT
  • BM infiltration pattern
  • Serum thymidine kinase (TK)
  • FISH aberrations
  • Gene mutations esp TP53
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49
Q

What is the definition of B-prolymphocytic leukemia (B-PLL)?

A

A condition characterized by >55% prolymphocytes in the blood.

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50
Q

What are the key features of hairy cell leukemia (HCL)?

A
  • Abnormal lymphocytes
  • Monocytopenia
  • Pancytopenia
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51
Q

What differentiates HCL from HCL variant (HCLv)?

A
  • HCL: Often causes pancytopenia
  • HCLv: Immature cells, prominent nucleolus, raised WCC
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52
Q

What are the common laboratory findings in low-grade lymphomas?

A
  • Abnormal lymphocytes
  • Possible autoimmune hemolysis
  • Possible hyposplenic features
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53
Q

What is HCL often associated with?

A

Pancytopenia, especially neutropenia and monocytopenia.

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54
Q

What are the characteristics of HCLv?

A

Immature cells with a prominent nucleolus and raised WCC.

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55
Q

What are some features of SMZL?

A

Intrasinusoidal lymphoma cells, splenomegaly, villous lymphocytes.

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56
Q

What is the molecular test used for WM?

A

Lymphoid panel, MYD88.

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57
Q

What is noted about cryoglobulins in WM?

A

10% of patients may develop cryoglobulins.

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58
Q

What are the flow cytometry markers for SMZL?

A
  • 5-
  • 10+
  • 20+
  • 22+
  • 23-
  • 79a+
  • 43-
  • Mod/st SmIg
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59
Q

What genetic translocations are associated with MZL?

A

t(14;18) and t(11;18).

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60
Q

What immunophenotype is associated with follicular lymphoma?

A
  • CD45
  • 20
  • 5
  • 10
  • 4
  • 8
  • 3
  • 38
  • K/L
61
Q

What is a key morphological feature of DLBCL?

A

Large cells.

62
Q

What are the clinical correlations for DLBCL?

A
  • LDH
  • PB flow
  • BMAT
  • IHC: CD20/CD3, P53
63
Q

What indicates a double hit lymphoma?

A

MYC: BCL2 or MYC:BCL6.

64
Q

What is required for diagnosis of plasma cell leukemia?

A

> 20% plasma cells or >2 x 10^9/L.

65
Q

What are the features of myeloma?

A
  • Plasma cells >10% in BM
  • Solitary plasmacytoma
  • End organ damage: CRAB.
66
Q

What are common features of autoimmune hemolysis?

A
  • Spherocytes
  • Polychromasia.
67
Q

What does MGUS stand for?

A

Monoclonal Gammopathy of Undetermined Significance.

68
Q

What is the significance of LDH in hematological disorders?

A

It is often elevated in malignancies and hemolytic processes.

69
Q

What is a common genetic abnormality in mantle cell lymphoma?

A

t(11;14) involving CCND1:IgH.

70
Q

What are the clinical correlations for T-cell NHL?

A
  • LDH
  • BMAT
  • IHC: CD3/20, CD4/8, CD30, ALK.
71
Q

What is a characteristic feature of mycosis fungoides/sezary?

A

Cerebriform or convoluted nuclei.

72
Q

What are Reed-Sternberg cells associated with?

A

Hodgkin lymphoma.

73
Q

What is the hallmark of fragmentation hemolysis?

A

Anaemia and thrombocytopenia with fragments.

74
Q

What is a common test for autoimmune hemolytic anemia?

A

Haemolytic screen.

75
Q

What does the presence of Heinz bodies indicate?

A

Oxidative hemolysis.

76
Q

What are the features of hereditary elliptocytosis?

A
  • Marked poikilocytosis
  • Ovalocytes.
77
Q

What is the clinical relevance of t(2;5)?

A

It is associated with anaplastic large cell lymphoma.

78
Q

What does the term ‘starry sky’ refer to?

A

A histological pattern seen in Burkitt lymphoma.

79
Q

What is the E5M test used for?

A

Eosin-5-Maleimide test for detecting membrane defects.
E5M – measures the reduced fluorescence intensity of E5M-labelled red cells. Reduced fluorescence is also found in CDA II, & SEA-ovalocytosis but morphologically different.
- E5M (dye) binds to anion transport protein (band 3) at lysine -430

80
Q

What are causes of marked poikilocytosis?

A
  • Congenital dyserythropoietic anemias
  • Acquired dyserythropoietic anemias
  • Hereditary pyropoikilocytosis
  • HbH disease
  • Hereditary stomatocytosis
  • Alcohol consumption
81
Q

What are stomatocytes and macrothrombocytopenia associated with?

A

Phytosterolemia

82
Q

What is the clinical correlation for hemolytic anemia?

A
  • Family history
  • Hemolytic screen
  • E5M test
83
Q

What does the triad of PNH include?

A
  • Hemolysis
  • Bone marrow failure
  • Thrombosis
84
Q

What are the types of GPI-linked proteins in PNH?

A
  • Type I: normal
  • Type II: partially reduced
  • Type III: absent
85
Q

What are some congenital causes of pancytopenia?

A
  • Fanconi anemia
  • Dyskeratosis congenita
  • Shwachman-Diamond syndrome
86
Q

Fill in the blank: The presence of _______ can indicate a viral infection.

A

Parvovirus B19

87
Q

What are common causes of macrothrombocytopenia?

A
  • Congenital disorders
  • Myeloproliferative neoplasms (MPN)
  • Drugs such as sulfa and quinine
88
Q

What syndrome is associated with large platelets?

A

May-Hegglin anomaly

89
Q

What is the significance of a thick film in malaria diagnosis?

A

It helps detect red cell parasitic inclusions

90
Q

What are the features of a clostridium sepsis infection?

A
  • Microspherocytes
  • Ghost cells
91
Q

What are the expected findings post-splenectomy?

A
  • Target cells
  • Acanthocytes
  • Howell-Jolly bodies
92
Q

What is the clinical significance of Dohle bodies?

A

They indicate a May-Hegglin anomaly

93
Q

What are the morphological features of Burkitt’s lymphoma?

A
  • Monomorphic medium-sized blastic cells
  • Vacuolated cytoplasm
94
Q

What does AML M4 with eosinophilia indicate?

A

Acute myelomonocytic leukemia

95
Q

What is the role of HPLC in diagnosing HbH disease?

A

To analyze hemoglobin fractions

96
Q

What is the significance of ring sideroblasts?

A

Indicates megaloblastic anemia

97
Q

What are bite and blister cells associated with?

A

G6PD deficiency and oxidative hemolysis

98
Q

What are the symptoms of acute leukaemia?

A
  • Fatigue
  • Fever
  • Bleeding
99
Q

What is the diagnostic criterion for chronic eosinophilic leukemia?

A

Eosinophils >1.5 x 10^9/L for more than 6 months

100
Q

What is the common complication of sickle cell anemia?

A

Hyposplenism due to vaso-occlusive crises

101
Q

What are the signs of lead poisoning in blood smears?

A

Coarse basophilic stippling

102
Q

What does the diagnosis of Gaucher disease involve?

A

Enzyme assay for glucocerebrosidase deficiency

103
Q

What are the key features of G6PD deficiency?

A

Oxidative haemolysis, bite and blister cells, neutrophil vacuoles

G6PD deficiency can lead to hemolytic anemia under oxidative stress.

104
Q

What cytogenetic abnormality is associated with Ewing’s Sarcoma?

A

t(11:22)

Ewing’s Sarcoma is a type of bone cancer that typically affects children and young adults.

105
Q

What is a granuloma?

A

A compact aggregate of macrophages, may include epithelioid macrophages

Granulomas can be associated with various conditions, including infections and autoimmune diseases.

106
Q

What are some differential diagnoses for granuloma?

A
  • Infection: TB, MAC, Syphilis, Toxoplasmosis, Histoplasmosis, Cryptococcus, cat-scratch disease, herpes virus
  • Sarcoidosis
  • Malignancy: HL, NHL, MM, MF, ALL, MDS, PRV, Met carcinoma
  • Drug hypersensitivity: phenytoin, NSAIDS, Allopurinol, etc.
  • Reaction to foreign substances: Talc, Silicosis, berylliosis

Granulomas can arise from various stimuli, necessitating a broad differential diagnosis.

107
Q

What immunohistochemical markers are used in diagnosing certain granulomas?

A
  • CD61
  • CD68
  • CD15
  • CD30
  • AE1/3
  • Zeil Neilson (AFB)
  • PAS(+MAC, -TB)
  • GMS (fungi)

These markers help in identifying specific types of lymphoid neoplasms.

108
Q

What is required for the diagnosis of acute erythroid leukemia?

A

erythroid predominance, usually ≥ 80% of bone marrow elements, of which ≥ 30% are proerythroblasts

Erythroleukemia is a type of acute myeloid leukemia characterized by significant erythroid proliferation.

109
Q

What causes Adult T-cell leukemia/lymphoma?

A

HTLV-1

This virus is endemic in regions such as Japan and the Caribbean.

110
Q

What is the immunophenotype for Adult T-cell leukemia/lymphoma?

A
  • CD2+
  • CD3+
  • CD5+
  • CD7-
  • CD4+
  • CD8-
  • CD25+

This immunophenotypic profile is characteristic of malignancies associated with HTLV-1.

111
Q

What is Gaucher’s Disease characterized by?

A

Glucocerebrosidase deficiency leading to accumulation of glucocerebroside in macrophage lysosomes

This genetic disorder affects lipid metabolism.

112
Q

What are the common causes of mononucleosis syndrome?

A
  • EBV
  • CMV
  • HIV
  • Hepatitis
  • Toxoplasmosis
  • Post vaccination

Mononucleosis syndrome is often viral in nature and can present with similar symptoms.

113
Q

What differentiates iron deficiency anemia from thalassemia?

A
  • RDW increased in iron deficiency
  • RCC decreased in iron deficiency

Both conditions present with microcytic/hypochromic red blood cells but have different underlying causes.

114
Q

What are the types of Congenital dyserythropoietic anemia (CDA)?

A
  • Type I: macrocytic, internuclear chromatin bridges
  • Type II (HEMPAS): normocytic, bi & multinuclearity
  • Type III: normocytic, giant erythroblasts, marked multinuclearity

CDA is a group of inherited disorders affecting red blood cell production.

115
Q

What is required for the diagnosis of CMML-1?

A

Monocytosis >1 x10^9/L for 3 months, PB Blasts <5%, BM <10%

Chronic Myelomonocytic Leukemia (CMML) can be classified into two subtypes based on blast counts.

116
Q

What are the features of spur cell hemolysis etoh related?

A

Anisopoikilocytosis, target cells, thrombocytopenia

Spur cells (acanthocytes) can be seen in liver disease and other conditions.

117
Q

What are features of Chediak-Higashi syndrome?

A

Inclusions, multilobated lymphocytes

This is a rare immunodeficiency disorder associated with partial oculocutaneous albinism.

118
Q

What are some causes of rouleaux formation?

A
  • Plasma cell neoplasms
  • Infection/inflammation
  • Pregnancy
  • Drugs
  • Artefact

Rouleaux formation is often seen in conditions with increased plasma proteins.

119
Q

What are the causes of hemolysis?

A
  • Intracorpuscular: Membrane disorders, defects in Hb production, defective red cell metabolism
  • Extracorpuscular: immune mediated, trapping, trauma, lead poisoning, mechanical, oxidant, drugs

Hemolysis can occur due to various intrinsic and extrinsic factors affecting red blood cells.

120
Q

What are the key findings in a definitive case of MAHA with TCP?

A
  • Red: Fragments/schistocytes, polychromasia, ?NRBC
  • White: ?Neutrophilia, left shifted, toxic changes ?leukoerythroblastic
  • Platelets: Marked thrombocytopenia

Microangiopathic Hemolytic Anemia (MAHA) can be associated with thrombocytopenia in various clinical contexts.

121
Q

What is hypersplenism?

A

A condition where the spleen is overactive, leading to excessive removal of blood cells.

122
Q

What are acanthocytes?

A

Abnormal red blood cells with irregular projections, often associated with liver disease.

123
Q

What is microangiopathic haemolytic anaemia (MAHA)?

A

A type of anaemia characterized by the destruction of red blood cells due to small blood vessel abnormalities.

124
Q

What are schistocytes?

A

Fragmented red blood cells commonly seen in MAHA.

125
Q

What does polychromasia indicate?

A

The presence of red blood cells of varying colors, typically indicating reticulocytosis.

126
Q

What is thrombocytopenia?

A

A condition characterized by abnormally low levels of platelets in the blood.

127
Q

What are possible causes of MAHA?

A
  • Thrombotic thrombocytopenic purpura (TTP) * Hemolytic uremic syndrome (HUS) * Drug-mediated thrombotic microangiopathy (TMA) * Malignancy-associated TMA * Complement-mediated aHUS.
128
Q

What is oxidative haemolysis?

A

Destruction of red blood cells due to oxidative stress, often exhibiting specific morphological features.

129
Q

What are bite cells?

A

Red blood cells that appear to have had ‘bits’ removed, often associated with oxidative haemolysis.

130
Q

What is hyposplenism? Blood film features

A

A condition where the spleen is underactive, leading to decreased removal of blood cells.

*Red cells: Target cells, acanthocytes, Howell-Jolly bodies, Pappenheimer bodies, occasional NRBC, rare spherocytes
*White cells: lymphocytosis (often LGL), monocytosis
*Platelets: Thrombocytosis/high-normal

*If unstable Hb/oxidant drug and Heinz bodies are being formed – large numbers seen when pitting action of spleen lacking
*If erythroblast iron overload (sideroblastic anaemia, thalassaemia major) Pappenheimer bodies are very numerous
*If BM megaloblastic or dyserythropoietic Howell-Jolly bodies are numerous

131
Q

What are target cells?

A

Red blood cells with a bullseye appearance, often associated with hyposplenism or thalassemia.
- Liver disease, obstructive jaundice, alcohol, post splenectomy, iron def, haemoglobinopathy

132
Q

What is spherocytic haemolysis?

A

A type of haemolysis characterized by the presence of spherocytes, often linked to immune disorders.

133
Q

What is the significance of Howell-Jolly bodies?

A

Nuclear remnants in red blood cells, indicating hyposplenism or splenic dysfunction.

134
Q

What are the key features of thalassaemia?

A
  • Hypochromic/microcytic red blood cells * Anisopoikilocytosis * Target cells * Basophilic stippling.
135
Q

What is Acute Promyelocytic Leukaemia (APML)?

A

A subtype of acute myeloid leukaemia characterized by promyelocytes with heavy granulation. PML RARA t(15;17)

136
Q

What are gametocytes?

A

Mature sexual forms of the malaria parasite found in infected red blood cells.

137
Q

What is a low-grade lymphoproliferative disorder?

A

A type of cancer characterized by the proliferation of lymphocytes, typically with indolent behavior.

138
Q

What does leukoerythroblastic mean?

A

A term describing a blood film with immature white blood cells (left shift) and nucleated red blood cells.

139
Q

What are Auer rods?

A

Cytoplasmic inclusions found in myeloid leukaemia cells

140
Q

What are the common features of plasma cell leukaemia?

A
  • Marked rouleaux formation * Excess circulating plasma cells * Proteinaceous background.
141
Q

What is the differential diagnosis for plasma cell neoplasms?

A
  • Multiple myeloma * Lymphoplasmacytic lymphoma * Plasmablastic lymphoma.
142
Q

What does a trephine biopsy showing increased fibrosis indicate?

A

Possible myeloproliferative neoplasm or other infiltrative disorders.

143
Q

What is the importance of reticulocyte count in a haemolysis screen?

A

It helps assess bone marrow response to anaemia.

144
Q

Fill in the blank: The presence of _______ in a blood film is indicative of oxidative stress-related haemolysis.

A

bite cells and blister cells

145
Q

What are the key immunohistochemistry (IHC) markers to consider?

A
  • CD45
  • CD20/3/PAX5
  • CD15/30
  • ALK
  • EBV
  • MCT
  • CD68
  • AE1/3
  • CK7/20

IHC markers help in identifying specific cell types and conditions.

146
Q

What does the lymphoid screening panel in Flow include?

A
  • CD45
  • CD20
  • CD5
  • CD10
  • CD4
  • CD8
  • CD3
  • CD38
  • K/L

Flow cytometry is used for analyzing the physical and chemical characteristics of cells.

147
Q

What is suggested by the film features regarding red cell membrane defects?

A

Eliptocytosis, ovalocytosis, HPP (hereditary pyropoikilocytosis). Features of hyposplenism and evidence of haemolysis, likely exacerbated by infection

HPP stands for hereditary pyropoikilocytosis.

148
Q

What is included in the differential diagnosis for the red cell membrane defect?

A

HPP (hereditary pyropoikilocytosis) and rare patients developing MDS

MDS stands for myelodysplastic syndromes.

149
Q

What further investigations are recommended in red cell membrane defect?

A
  • Haemolytic screen (DCT, haptoglobin, LDH, bilirubin, reticulocyte count)
  • Infectious marker (CRP)
  • Osmotic fragility test
    *E5M
  • Family studies
  • Biochemical investigation of red cell membrane

These tests help confirm the diagnosis and rule out other conditions.

Haematology Laboratory Exams 25 (13 decks)

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