In contrast, a finding reported as elliptocytes present or tear drop cells present is considered non-specific because a small number of elliptocytes may be seen in the blood smears of patients with anemia of various etiologies and an occasional tear drop cell is not an uncommon finding in patients with iron deficiency anemia or renal disease.
Blood Cell Morphology Grading Guide, a recent publication from the American Society for Clinical Pathology Press ASCP Press , provides a systematic approach and thereby some level of standardization to grading and reporting morphologic abnormalities of red cells, white cells and platelets [ 18 ].
A BSR may be requested by the clinician or initiated by the laboratory staff. It may be performed with or without interpretation of findings. In many laboratories, at least the initial blood smears with potentially significant finding s , as determined by the pre-set criteria, are subjected to a review by a qualified hematomorphologist. Any person with expertise in blood cell morphology may serve as a qualified reviewer for confirmation of previously identified abnormal findings and for identifying those either unfamiliar to or missed by the initial blood smear examiner.
However, a physician, that may be a hematopathologist, hematologist, or pathologist with training and experience in hematology, is most suitable for interpretation of blood smear findings in the light of other relevant clinical and laboratory information. The list of criteria for smear review is usually developed by individual laboratories with input from pathologist s , clinicians, and the hematology supervisory staff, and may be updated periodically as deemed appropriate.
Although, clinical significance of the abnormal CBC and DIFF findings is the major determining factor in deciding which blood smears need review, several other factors may also influence such a decision. These factors may include patient population served, clinicians' concerns pertaining to specific patient populations, training and experience of blood smear examiners s and reviewer s , workload of the laboratory and the reviewer s , initial vs.
Published criteria [ 19 - 22 ] may be used by individual laboratories as a starting point in the process of developing their own set of criteria. Blood smear review by a qualified hematomorphologist can serve several functions that are considered essential to good patient care. Interpretation of blood smear findings along with CBC and other available laboratory data in the clinical context may provide a definite diagnosis or suggest a strategy for additional work-up of the case in an efficient and cost-effective manner.
Furthermore, blood smear review can serve as an excellent teaching resource for training of students, residents, fellows and newly hired staff, and for continuing education of the technical staff. Blood smear review process encompasses every aspect of the blood smear scan and the blood smear examination described above, with one exception. The exception is that the reviewer may or may not choose to perform the actual cell DIFF. The circumstances, which will necessitate a cell DIFF by the reviewer include a if the review is being performed also for the purpose of QC for the DIFF or for assessing competency of the staff in performing manual DIFF and b if, in the judgement of the reviewer, the DIFF results reported by the blood smear examiner are either incomplete, inaccurate, or contain some unidentifiable cells reported as other cells with or without any comments.
A blood smear review by a physician often generates a written report with interpretation of the findings in the clinical context.
Blood smear reviewers often serve as consultants to clinicians and other laboratory professionals in explaining the abnormal findings and their clinical relevance, besides providing either a diagnosis whenever feasible or suggesting an appropriate strategy for an efficient and cost-effective additional work-up necessary for arriving at a diagnosis. A blood smear scan serves to at least a verify the flagged automated hematology results and b determine if a manual DIFF needs to be performed.
National Center for Biotechnology Information , U. Journal List Ann Lab Med v. Ann Lab Med. Published online Dec Gene Gulati , Ph. Find articles by Gene Gulati. Find articles by Jinming Song. Find articles by Alina Dulau Florea.
Find articles by Jerald Gong. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Corresponding author: Gene Gulati. This article has been cited by other articles in PMC. Abstract A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a number of circumstances and for a variety of reasons.
Keywords: Blood smear scan, Blood smear examination, Blood smear review. Open in a separate window. Table 3 Significant morphologic abnormalities.
References 1. Lab Med. Int J Lab Hematol. Performance evaluation of the latest fully automated hematology analyzers in a large commercial laboratory setting: A 4-way, side-by-side study. Lab Hematol. If I put them in sideways, the sides are cut way off. If I put it in up-and-down, then the top and bottom of the slides are cut off.
I have tried this with the setting also, in case, and it gets a little more of the 'picture' but still not all. Something is not set right to allow scanning of the entire slide.
This seems to be an issue with the scanner design not allowing more of the 'picture' to be scanned. It would be nice if the different adapters would have been longer about the same length as the adapter. It is hard to find the correct spot to insert them if you don't have enough light on that side. It also would be nice to be able to power the scanner without having to have it plugged in to the computer all of the time. I like to do some scanning when I'm doing something else either on the computer or not and would like to be able to do so without having to unplug the scanner from the computer to use, then plug it back into the computer to transfer the scans.
A separate power port maybe? This is not a professional scanner and isn't meant to be one, and I understand this. However, there are some 'small' issues that should be addressed Time and Date and the slide feed tray that would make it better. My parents had several loaded slide trays for viewing on a projector from mid 's thru early part of the 's. Many of these slides were of my younger years growing up on the family farm and I wanted to convert them to digital.
I had projected the slides onto a projector screen and took a picture of the screen with a 4K camera, then enhanced in PhotoShop. This worked, but still not the greatest results so I began an internet search before selecting the Kodak Slide-n-Scan. The difference is quality was unbelievable. I had 3 or more pics that I couldn't digitalize satisfactory without converting them to black and white using the projector. I ended up a nice colorful, digital copy of every slide!
I still ran the scanned image thru Photoshop as I think removing the haze or dehazing the pictures can make a big difference along with other minor tweaks. I even dehaze most of my 4K or 3D pictures that I take now before using them in Shutterfly or making a stereo card out of them, etc.
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