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The page below is a sample from the LabCE course White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Additional Comments

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:

  1. Atypical lymphocytes, suggesting infectious mononucleosis rather than leukemia
  2. Toxic granules in neutrophils, as found in acute infections, or atypical granules suggesting a genetic disorder
  3. An unusual mix of cells, such as too many or too few neutrophils, monocytes, or other myeloid cells
  4. 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.