The following pages in this presentation includes a series of white blood cell and platelet abnormalities (nonneoplastic) that may be identified in a peripheral blood smear. Many cases will simulate the practice of a peripheral smear review by a hematology technologist. He or she must assess what responses in patient care may be triggered by the clinician attempting to interpret the reported findings on a peripheral smear.
Observations of white blood cell abnormalities in the peripheral blood smear should be reported in order to direct the physician to an immediate specific diagnosis, such as:
- Atypical lymphocytes, suggesting infectious mononucleosis rather than leukemia
- Toxic granules in neutrophils, as found in acute infections, or atypical granules suggesting a genetic disorder
- An unusual mix of cells, such as too many or too few neutrophils, monocytes, or other myeloid cells
- The presence of giant platelets, myelocytes, or other cells, suggesting a myelodysplastic syndrome
In summary, laboratory data should be presented to clinicians in a user-friendly fashion to promote effective decision making.