Evaluation of Cell Morphology and Introduction to Platelet and White Blood Cell Morphology

OBJECTIVES At the end of the chapter, the learner should be able to: 1. Define the terms flagged and reflex test as they pertain to automated hematology results. 2. Describe the importance of maintaining competency in morphological identification. 3. List justifications for performing a manual morphology review. 4. List the steps in the performance of a peripheral blood smear examination. 5. Identify normal red blood cell morphology on a peripheral smear. 6. List the terms referring to abnormal red cell distribution, variation in red cell size, and variations in red cell color/hemoglobin content, being able to identify each abnormality on a peripheral smear and specify the particular clinical conditions associated with these abnormalities. 7. Define anisocytosis and poikilocytosis and list clinical conditions in which they may be reported. 8. Define the terms normochromic, hypochromic, microcytic, and macrocytic as they relate to red cell indices. 9. Correlate red cell indices with red cell morphology and the diagnosis of anemia. 10. Define the following terms: target cells, spherocytes, ovalocytes, elliptocytes, stoma-tocytes, and be able to identify these cells on a peripheral smear. 11. List diseases that may show fragmented red cells and describe their pathophysiology. 12. Describe the most common red blood cell inclusions and their composition, relating each inclusion to clinical conditions in which they may be found. 13. Correlate pathophysiology of clinical conditions associated with abnormal appearance of red cells noted on the peripheral blood smear. 14. Describe normal platelet morphology and specify some platelet abnormalities seen in pathologic conditions. 15. List conditions showing leukocyte cytoplasmic as well as nuclear changes.