It offers complete coverage of the basics of hematologic morphology, including examination of the peripheral blood smear, basic maturation of the blood cell lines, and discussions of a variety of clinical disorders. It remains a frontline diagnostic in unraveling mysteries behind cryptic symptoms and signs in primary and secondary haemopathies. Welcome,you are looking at books for reading, the the smear, you will able to read or download in pdf or epub books and notice some of author may have lock the live reading for some of country. The pbf exposes the morphology of peripheral blood cells, which ensures its. You may do so in any reasonable manner, but not in any.
With your right hand, place the smooth clean edge of a second spreader slide on the specimen slide, just in front of the. Preparation of smear there are three types of blood smears. Utmedical school at houston, pathology last revision on. The peripheral blood film remains a very useful tool in hematological assessment. This has motivated researchers to develop different algorithms and methods to automate peripheral blood smear image analysis. Jul 15, 2019 a peripheral blood smear examination is a procedure, which involves spreading a drop of blood thinly onto a glass slide. Introduction to peripheral blood smear examination clinical. Systematic histologic examination of the bone marrow and lymph nodes is beyond the scope of a general medicine textbook. Tip sheet rice laboratory peripheral smear morphology sample. Peripheral blood smear image examination is a part of the routine work of every laboratory. Peripheral blood clues to nonneoplastic conditions online ce course. A blood smear reveals information about the number and shape of blood cells in the body. Oct 18, 2016 preparation of smear there are three types of blood smears. During the first week of illness a microscopic examination of a peripheral blood smear might reveal morulae microcolonies of anaplasmae in the cytoplasm of granulocytes and is highly suggestive of a diagnosis.
A well prepared blood smear is necessary for microscopic examination of blood. The best place to examine blood cell morphology is the feathered edge of the blood smear where red cells lie in a single layer, side by side, just barely touching one another but not overlapping. A phlebotomist, a person specifically trained to draw blood, first cleans and sterilizes the injection site with an antiseptic. The white blood cells are decreased in number and consist mostly of blasts 41% as reported on the differential. The other is pusher or the spreader slide drop of blood 23 mm in diameter. Reporting of the peripheral blood smear was done on a predefined pretested reporting form by two haematologists blinded to the diagnosis. The feathered edge should be scanned for platelet clumps, large cells and microfilaria. Second, appearance of the organism in peripheral blood, especially in cats, can be. The stacking of cells rouleaux formation facilitates the rate of red cell sedimentation, a phenomenon that may be seen on a peripheral smear. Mar 28, 2014 peripheral blood smear image examination is a part of the routine work of every laboratory. Peripheral blood smear clinical methods ncbi bookshelf.
In myelodysplastic syndromes, blood cells have an abnormal shape or size dysplasia. Below is a slide at high magnification under an oil immersion lens. It is limited to the material covered in the lectures and laboratory sessions. The classic blood smear has a thumb print appearance. The red cells are decreased in number and are normochromic and macrocytic. Get ebooks the peripheral blood film on pdf, epub, tuebl, mobi and audiobook for free. Although advances in automated technology have made the examination of a peripheral blood smear by a physician seem less important, the technology is not a completely satisfactory replacement for a blood smear interpretation by a trained medical professional who also knows the patient. A peripheral smear test can be used to diagnose, monitor numerous conditions and blood diseases that affect population of blood cells. Blood smears are used to determine leukocyte differentials, to evaluate erythrocyte, platelet and leukocyte morphology, and, if necessary, to estimate platelet and leukocyte counts. Highquality, bevelededge microscope slides are recommended.
This is a trashy smear, but it does show an extremely advanced case of the microcytichypochromic anemia characteristic of iron deficiency. Data on statistical significance of proportions was analysed using the. Place a drop of blood, about 23 mm in diameter approximately 1 cm from one end of slide. It is not appropriate to use the same edge of a slide for more than a single film. Blood smear from a 68yearold woman with a year history of polycythemia vera treated with phlebotomy, 32p, and hydroxyurea.
Jun 01, 2006 the cbc was normal except for thrombocytopenia. Chronic myelomonocytic leukemia cmml is a type of leukemia, which are cancers of the blood forming cells of the bone marrow. Complete blood count with indices mcvindication of rbc size rdwindication of rbc size variation examination of the peripheral blood smear reticulocyte count measurement of newly produced young rbcs stool guiac. The manual examination of these images is tedious, timeconsuming and suffers from interobserver variation. Scroll left and right to see various peripheral blood components.
Atlas of hematology and analysis of peripheral blood smears. Atlas of canine and feline peripheral blood smears vetbooks. The blood can be obtained from finger heal microhematochrit tubes non heparinised for edta or heparinised for capillary blood wooden stick or glass capillary pipette. The authors approach is to look at the smallest cellular elements, the platelets, first and work his way up in size to red cells and then white cells. Morphologyedta whole blo edta whole blood minimum of 0. A sedimentation rate was markedly elevated, and his peripheral smear. Figure e174 figure e177iron deficiency anemia next to normal red blood cells. Proper preparation of a peripheral blood smear objective at the completion of this laboratory, the student will be able to.
The book will illustrate the morphologic features on peripheral blood smears of the various disorders and the text will focus on diagnostic criteria, differential diagnosis and modern classification terminology. There is mild variation in size anisocytosis but no real variation in shape poikilocytosis. Blood smear, peripheral by pathologist, with written report cpt 85060 test id. Peripheral blood clues to nonneoplastic conditions. Using a capillary tube, place a 23mm drop of blood about 1cm from the frosted end of a clean slide that is on a flat surface. The mean corpuscular volume mcv was 55 fl reference range.
Examination of the peripheral blood smear begins on low power. It is then treated with a special stain and studied under a microscope to examine the blood cells. Peripheral blood smear can be used for estimation of manual blood counts. Systemic mastocytosis in 16 dogs wiley online library. Download the smear or read online books in pdf, epub, tuebl, and mobi format. Invert tube 8 to 10 times immediately after tube is filled at the time of collection. Peripheral blood smear test is ordered as part of a general health exam to help diagnose many illnesses it helps diagnose if red blood cells, white blood cells and platelets are normal in appearance and number. Can findings on peripheral blood smear differentiate.
This file is licensed under the creative commons attribution 2. The presentation of illustrative cells in this module is by no means a comprehensive study of blood cells. Blood consists of three types of cells suspended in fluid called plasma. Hematopathology consultation, peripheral smear labcorp. Always update books hourly, if not looking, search in the book search column. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification. The dense body of the smear takes up most of the slide and there is a thin counting area which blends with the feathered edge and the dense body. Review of the smear is an important adjunct to other clinical data. Unfortunately, a few cell illustrations are not available at this time but will be added.
There are more than 1 million books that have been enjoyed by people from all over the world. A peripheral smear a smear examined by a pathologist is primarily ordered to evaluate blood cell populations when a complete blood count with differential cbcd, performed with an automated blood cell counter, indicates abnormal white blood cells, red blood cells, or. The wedge smear the cover glass smear the spun smear the are two additional types of blood smear used for specific purposes buffy coat smear thick blood smears for blood parasites 10. Microcytes right panel are smaller than normal red blood cells cell diam eter findings in peripheral blood, enlarged lymph nodes, and bone marrow are illustrated in this chapter. Dec 12, 20 complete blood count results revealed a white blood cell count of 38. They then tie a band above the venous site where your blood will be drawn.
Over 1,000 fullcolor photomicrographs depict abnormalities within each blood cell line, with multiple pictures of each morphologic abnormality and. With the advent of hematological automated machines, complete and highly accurate hematological data and parameters can be obtained within a few minutes. As basic as it is, pbf is invaluable in the characterization of various. The examination of blood films stained with wrights stain frequently provides important clues in the diagnosis of anemias and various disorders of. Mar 29, 2018 patients age, sex and automated full blood count fbc reports were provided to the haematologist. We will discuss about the diagnosis of rbc, wbc and platelets morphologic abnormalities from the peripheral blood smear. This article highlights the basic science and art behind the pbf. Moderate anisopoikilocytosis occasional oval macrocytes, dacrocytes, and elliptoid cells is seen. Red blood cells display normal orange pink cytoplasm with central pallor 12 the diameter of the red cell.
Smears made from edtaanticoagulated blood should be made. An accurate peripheral blood smear report can elucidate a vast spectrum of hematologic disorders, guide further testing, and have a critical impact on patient care. A peripheral blood smear is a test in which a hematopathologist examines a drop of blood under a microscope to identify unusual changes in the number, size, shape, appearance and maturity of various blood cells. Peripheral blood smear procedure and interpretation. An illustrated guide to the morphology of blood cells, atlas of canine and feline peripheral blood smears covers patient assessment for common hematologic disorders and diseases in dogs and cats. Peripheral blood film or peripheral blood smear or peripheral smear examination forms an important and basic lab investigation for diagnosing a number of hematological blood disorders. State the appropriate sample used for preparing a peripheral blood smear. Jacobs, dvm the clinical and pathologic features of systemic mastocytosis in 16 dogs are reported. The slides should be dried as quickly as possible to prevent. Peripheral blood smear test procedure the blood smear test is a simple procedure in which your health care provider draws a blood sample from the vein in your arm. Peripheral blood test your knowledge below is a slide at high magnification under an oil immersion lens. Artifacts, artifactual changes in blood cells, contaminants, and miscellaneous findings, along with an approach to blood smear examination, are covered in the 1st section. Rouleaux formation blood american society of hematology.
There was no apparent breed or sex predilection, and the median age at presentation was 9. Guillermo couto, dvm, cheryl burkeschwartz, dvm, and robert m. Peripheral blood smear test about, preparation, test. Only 4 patients had definite lymphoma cells seen on peripheral blood smear.
Color atlas of clinical laboratory medicine first version. Introduction to peripheral blood smear examination oncohema key. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification purposes. However, every internist should know how to examine a peripheral blood smear. Prepare a second smear by repeating steps 35, using the edge of the first slide to spread a drop of blood on the second slide. Pdf the peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide.
Neel, dvm, dacvp clinical associate professor, clinical pathology nc state college of veterinary medicine raleigh, nc, 27607 introduction although tremendous advances have been made in the field of pointofcare hematology analyzers, examination of a well prepared, well stained blood smear remains the. Blood films are examined in the investigation of hematological blood disorders and are routinely employed to look for blood parasites, such as those of malaria and filariasis. Examination of the peripheral blood smear is an inexpensive but powerful diagnostic tool in both children and adults. To the right is a typical neutrophil with the usual 3 segmentations of the nucleus.
There was a 6to 7month history of decreasing hemoglobin level and platelet count. The peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide. A blood filmor peripheral blood smearis a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically. Peripheral smear clues for bordetella pertussis blood. Jun 12, 2016 making the peripheral blood smear although some automated analyzers prepare and stain blood smears according to established criteria, manual blood smear preparation is still used in many places. These are the same cases that you studied in the two labs the normal smear is in there as well. This book will be a fullcolor atlas of both benign and neoplastic proliferations in the blood.
Although advances in automated technology have made the examination of a peripheral blood smear by a physician seem less important, the technology is not a completely. Making the peripheral blood smear although some automated analyzers prepare and stain blood smears according to established criteria, manual blood smear preparation is still used in many places. However, blood smear examination is relatively insensitive and should not be relied upon solely to diagnose anaplasmosis. Tutorial blood cell morphology a clinical pathology 201. Introduction to peripheral blood smear examination. Peripheral blood smear test purpose, procedure, results. Peripheral blood smear examination linkedin slideshare. The common clinical indications for peripheral blood film pbf exposes the morphology of peripheral blood analysis include unexplained cytopenia.
Place the slide on a flat surface, and hold the other end between your left thumb and forefinger. As basic as it is, pbf is invaluable in the characterization of various clinical diseases. A blood smear is a laboratory procedure for examination of a small drop of blood spread over a glass slide. Synoptic reporting system for peripheral blood smear. Interpreting peripheral blood smears harrisons principles. In cmml, there are increased numbers of monocytes and immature blood cells in the peripheral blood and bone marrow, as well as abnormal. Tube filled to capacity and two freshly prepared blood films. The morphology and clinical relevance of red cells, white cells, and platelets, and their respective precursors, both normal and. Clinical and laboratory diagnosis anaplasmosis cdc. The investigator or delegated person should follow protocol specific guidelines for. Morphologic examination of the peripheral blood smear revealed numerous mature lymphocytes with.
In adults, blood cells are formed in the bone marrow, by a process that is known as haematopoiesis. Stained peripheral blood smear is examined carefully using 40 x to 100 x objective usually oil immersion lens 2. The page below is a sample from the labce course red cell disorders. Peripheral blood or potassium edta anticoagulated blood 12 mg edta1 ml blood may be used. This blood test provides information about the number and shape of blood cells by visual inspection by microscope. Automated machines that deliver increasingly sophisticated data about blood counts and morphology tend to generalize and include a wide array of morphologic abnormalities. Describe the appearance of a well prepared blood smear. The examination and interpretation of peripheral blood smears is an important component of clinical pathology. A blood filmor peripheral blood smear is a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically. The examination of a peripheral blood smear is one of the most informative exercises a physician can perform.
1525 140 159 506 923 491 559 262 528 293 1462 393 1352 1455 901 1337 978 330 1181 902 1330 799 120 736 395 379 1300 459