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Blood Smear Morphology
|Performed by||Parnassus, Mission Bay & Mt. Zion Hematology|
|In House Availability||24 hours a day|
|Method||Microscopic examination of Wright-Giemsa stained smear|
|Container type||Lavender top|
|Amount to Collect||1 mL blood|
|Sample type||EDTA whole blood|
|Preferred volume||1 mL blood|
|Critical value||Blasts not previously identified|
|Synonyms||Red cell morphology; Howell-Jolly bodies; Leukocyte morphology; WBC morphology; Schistocyte; Acanthocyte; Macrocyte; Microcyte; Spherocyte; Ovalocyte; Dacrocyte; Target cell; Burr cell; Hypersegmentation; Hyposegmentation; Pseudo Pelger-Huet; Atypical lymphocyte; Variant lymphocyte; Blast; Myeloblast; Lymphoblast; NRBC; Nucleated red cell; Nucleated red blood cell; Dohle bodies; Pappenheimer bodies; Plasma cell; Promyelocyte; Myelocyte; Metamyelocyte; band; Seg; Segmented neutrophil; PMN|
|Additional information|| Automatically included when Automated Differential is inadequate and a Manual Differential must be done.
WBC abnormalities reported include blasts, immature granulocytes, hyposegmented and hypersegmented neutrophils, toxic granulation, Dohle bodies, inclusions, variant lymphocytes and abnormal lymphocytes.
Platelet abnormalities reported include hypo- and agranular platelets, giant platelets and megakaryocyte nuclear fragments.
Small numbers of RBCs with "abnormal" morphology may be seen in smears from normal individuals. In an effort to simplify and standardize the reporting of smears, the Clinical Laboratories reports the average number of abnormal RBCs seen in at least 10 high power fields (/HPF). The relation of these numbers to qualitative reports is shown below.
Abnormal RBCs per high power field (/HPF)
anisocytosis: RBCs vary markedly in size. MCV variable.
bite cells: one or more peripheral "bite"-like defects in a cell with decreased central pallor
coarse basophilic stippling: diffuse purple inclusions
dimorphic smear: two distinct populations of cells, usually one normocytic and normochromic, the other microcytic and hypochromic
hgb C crystals: rhomboid-shaped, with parallel sides and triangular or sloping ends
hgb SC crystals: irregular, contracted hyperchromatic cells with hgb C crystal-like projections
hypochromia, severe: many RBCs with greatly increased central pallor
macroovalocyte: large ovalocyte often showing decreased central pallor
microorganisms: parasites (babesia, malaria), fungi or bacteria (including spirochetes)
Pappenheimer bodies: clusters of =2 small blue or blue-green inclu-
sions found focally in RBCs
rouleaux: several RBCs aligned like a stack of coins; only significant and reported if found in the optimal portion of the smear
* Automatically reviewed by a physician
See also CBC w/Differential and Parasites.
If unusual findings are noted a pathologist review and interpretation may be performed and separately billed for
|Medical Necessity?||Yes. Click here for more information|
|Last Updated||1/27/2015 2:12:47 PM|