-
Annals of Laboratory Medicine Jan 2013A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a... (Review)
Review
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. In this article, an attempt is made to delineate the purpose and criteria for blood smear examination in a variety of circumstances that are encountered in everyday laboratory hematology practice. A blood smear scan serves to at least (a) verify the flagged automated hematology results and (b) determine if a manual differential leukocyte count needs to be performed. Blood smear examination/manual differential leukocyte count with complete blood count (CBC) provides the complete hematologic picture of the case, at least from the morphologic standpoint. Blood smear review with or without interpretation serves to ensure that no clinically significant finding is missed, besides providing diagnosis or diagnostic clue(s), particularly if and when interpreted by a physician.
Topics: Blood Cell Count; Hematologic Tests; Humans; Leukocyte Count; Leukocytes; Medical Laboratory Personnel
PubMed: 23301216
DOI: 10.3343/alm.2013.33.1.1 -
American Family Physician Dec 2015An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal...
An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal ranges for the white blood cell count. A repeat complete blood count with peripheral smear may provide helpful information, such as types and maturity of white blood cells, uniformity of white blood cells, and toxic granulations. The leukocyte differential may show eosinophilia in parasitic or allergic conditions, or it may reveal lymphocytosis in childhood viral illnesses. Leukocytosis is a common sign of infection, particularly bacterial, and should prompt physicians to identify other signs and symptoms of infection. The peripheral white blood cell count can double within hours after certain stimuli because of the large bone marrow storage and intravascularly marginated pools of neutrophils. Stressors capable of causing an acute leukocytosis include surgery, exercise, trauma, and emotional stress. Other nonmalignant etiologies of leukocytosis include certain medications, asplenia, smoking, obesity, and chronic inflammatory conditions. Symptoms suggestive of a hematologic malignancy include fever, weight loss, bruising, or fatigue. If malignancy cannot be excluded or another more likely cause is not suspected, referral to a hematologist/oncologist is indicated.
Topics: Education, Medical, Continuing; Humans; Leukocyte Count; Leukocytes; Leukocytosis; Practice Guidelines as Topic
PubMed: 26760415
DOI: No ID Found -
International Journal of Laboratory... Apr 2012Schistocytes are fragments of red blood cells (RBCs) produced by extrinsic mechanical damage within the circulation. The detection of schistocytes is an important...
Schistocytes are fragments of red blood cells (RBCs) produced by extrinsic mechanical damage within the circulation. The detection of schistocytes is an important morphological clue to the diagnosis of thrombotic microangiopathic anemia (TMA). Reporting criteria between different laboratories, however, are not uniform, owing to variability of shape and nature of fragments, as well as subjectivity and heterogeneity in their morphological assessment. Lack of standardization may lead to inconsistency or misdiagnosis, thereby affecting treatment and clinical outcome. The Schistocyte Working Group of the International Council for Standardization in Haematology (ICSH) has prepared specific recommendations to standardize schistocyte identification, enumeration, and reporting. They deal with the type of smear, method of counting, morphological description based on positive criteria (helmet cells, small, irregular triangular, or crescent-shaped cells, pointed projections, and lack of central pallor). A schistocyte count has a definite clinical value for the diagnosis of TMA in the absence of additional severe red cell shape abnormalities, with a confident threshold value of 1%. Automated counting of RBC fragments is also recommended by the ICSH Working Group as a useful complement to the microscope, according to the high predictive value of negative results, but worthy of further research and with limits in quantitation.
Topics: Erythrocyte Count; Erythrocytes, Abnormal; Humans; Purpura, Thrombotic Thrombocytopenic
PubMed: 22081912
DOI: 10.1111/j.1751-553X.2011.01380.x -
Medical & Biological Engineering &... Sep 2022Anemia is a blood disorder which is caused due to inadequate red blood cells and hemoglobin concentration. It occurs in all phases of life cycle but is more dominant in... (Review)
Review
Anemia is a blood disorder which is caused due to inadequate red blood cells and hemoglobin concentration. It occurs in all phases of life cycle but is more dominant in pregnant women and infants. According to the survey conducted by the World Health Organization (WHO) (McLean et al., Public Health Nutr 12(4):444-454, 2009), anemia affects 1.62 billion people constituting 24.8% of the population and is considered the world's second leading cause of illness. The Peripheral Blood Smear (PBS) examination plays an important role in evaluating hematological disorders. Anemia is diagnosed using PBS. Being the most powerful analytical tool, manual analysis approach is still in use even though it is tedious, prone to errors, time-consuming and requires qualified laboratorians. It is evident that there is a need for an inexpensive, automatic and robust technique to detect RBC disorders from PBS. Automation of PBS analysis is very active field of research that motivated many research groups to develop methods using image processing. In this paper, we present a review of the methods used to analyze the characteristics of RBC from PBS images using image processing techniques. We have categorized these methods into three groups based on approaches such as RBC segmentation, RBC classification and detection of anemia, and classification of anemia. The outcome of this review has been presented as a list of observations.
Topics: Anemia; Erythrocyte Count; Erythrocytes; Female; Hematologic Tests; Humans; Image Processing, Computer-Assisted; Pregnancy
PubMed: 35838854
DOI: 10.1007/s11517-022-02614-z -
Clinical Microbiology and Infection :... Jul 2018
Topics: Humans; Lymphoma, Large B-Cell, Diffuse; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Neutrophils; Phagocytosis; Staphylococcal Infections
PubMed: 29649607
DOI: 10.1016/j.cmi.2018.03.035 -
Nature Communications Jul 2023Many hematological diseases are characterized by altered abundance and morphology of blood cells and their progenitors. Myelodysplastic syndromes (MDS), for example, are...
Many hematological diseases are characterized by altered abundance and morphology of blood cells and their progenitors. Myelodysplastic syndromes (MDS), for example, are a group of blood cancers characterised by cytopenias, dysplasia of hematopoietic cells and blast expansion. Examination of peripheral blood slides (PBS) in MDS often reveals changes such as abnormal granulocyte lobulation or granularity and altered red blood cell (RBC) morphology; however, some of these features are shared with conditions such as haematinic deficiency anemias. Definitive diagnosis of MDS requires expert cytomorphology analysis of bone marrow smears and complementary information such as blood counts, karyotype and molecular genetics testing. Here, we present Haemorasis, a computational method that detects and characterizes white blood cells (WBC) and RBC in PBS. Applied to over 300 individuals with different conditions (SF3B1-mutant and SF3B1-wildtype MDS, megaloblastic anemia, and iron deficiency anemia), Haemorasis detected over half a million WBC and millions of RBC and characterized their morphology. These large sets of cell morphologies can be used in diagnosis and disease subtyping, while identifying novel associations between computational morphotypes and disease. We find that hypolobulated neutrophils and large RBC are characteristic of SF3B1-mutant MDS. Additionally, while prevalent in both iron deficiency and megaloblastic anemia, hyperlobulated neutrophils are larger in the latter. By integrating cytomorphological features using machine learning, Haemorasis was able to distinguish SF3B1-mutant MDS from other MDS using cytomorphology and blood counts alone, with high predictive performance. We validate our findings externally, showing that they generalize to other centers and scanners. Collectively, our work reveals the potential for the large-scale incorporation of automated cytomorphology into routine diagnostic workflows.
Topics: Humans; Myelodysplastic Syndromes; Anemia; Anemia, Megaloblastic; Blood Cells; Neutrophils
PubMed: 37474506
DOI: 10.1038/s41467-023-39676-y -
Acta Cytologica 2021
Topics: COVID-19; Host-Pathogen Interactions; Humans; Killer Cells, Natural; SARS-CoV-2; T-Lymphocytes, Helper-Inducer
PubMed: 32799199
DOI: 10.1159/000510110 -
Blood Reviews Nov 2023Chronic lymphocytic leukemia (CLL) is a B cell neoplasm characterized by the accumulation of aberrant monoclonal B lymphocytes. CLL is the predominant type of leukemia... (Review)
Review
Chronic lymphocytic leukemia (CLL) is a B cell neoplasm characterized by the accumulation of aberrant monoclonal B lymphocytes. CLL is the predominant type of leukemia in Western countries, accounting for 25% of cases. Although many patients remain asymptomatic, a subset may exhibit typical lymphoma symptoms, acquired immunodeficiency disorders, or autoimmune complications. Diagnosis involves blood tests showing increased lymphocytes and further examination using peripheral blood smear and flow cytometry to confirm the disease. With the significant advancements in machine learning (ML) and artificial intelligence (AI) in recent years, numerous models and algorithms have been proposed to support the diagnosis and classification of CLL. In this review, we discuss the benefits and drawbacks of recent applications of ML algorithms in the diagnosis and evaluation of patients diagnosed with CLL.
Topics: Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Artificial Intelligence; B-Lymphocytes; Lymphoma; Machine Learning
PubMed: 37758527
DOI: 10.1016/j.blre.2023.101134 -
International Journal of Laboratory... May 2018Morphological review of the peripheral blood smear is still a crucial diagnostic aid as it provides relevant information related to the diagnosis and is important for... (Review)
Review
INTRODUCTION
Morphological review of the peripheral blood smear is still a crucial diagnostic aid as it provides relevant information related to the diagnosis and is important for selection of additional techniques. Nevertheless, the distinctive cytological characteristics of the blood cells are subjective and influenced by the reviewer's interpretation and, because of that, translating subjective morphological examination into objective parameters is a challenge.
METHODS
The use of digital microscopy systems has been extended in the clinical laboratories. As automatic analyzers have some limitations for abnormal or neoplastic cell detection, it is interesting to identify quantitative features through digital image analysis for morphological characteristics of different cells.
RESULT
Three main classes of features are used as follows: geometric, color, and texture. Geometric parameters (nucleus/cytoplasmic ratio, cellular area, nucleus perimeter, cytoplasmic profile, RBC proximity, and others) are familiar to pathologists, as they are related to the visual cell patterns. Different color spaces can be used to investigate the rich amount of information that color may offer to describe abnormal lymphoid or blast cells. Texture is related to spatial patterns of color or intensities, which can be visually detected and quantitatively represented using statistical tools.
CONCLUSION
This study reviews current and new quantitative features, which can contribute to optimize morphology through blood cell digital image processing techniques.
Topics: Blood Cells; Cell Shape; Color; Humans; Image Processing, Computer-Assisted; Microscopy
PubMed: 29741256
DOI: 10.1111/ijlh.12832 -
International Journal of Molecular... Jan 2021The aim of this study was to develop and evaluate matrix assisted LASER desorption ionization (MALDI) time-of-flight (TOF) mass spectrometry imaging (MSI) of blood...
The aim of this study was to develop and evaluate matrix assisted LASER desorption ionization (MALDI) time-of-flight (TOF) mass spectrometry imaging (MSI) of blood smear. Integrated light microscope and MALDI IT-TOF mass spectrometer, together with a matrix sublimation device, were used for analysis of blood smears coming from healthy male donors. Different blood plasma removal, matrix deposition, and instrumental settings were evaluated using the negative and positive ionization modes while agreement between the light microscopy images and the lateral distributions of cellular marker compounds served as the MSI quality indicator. Red and white blood cells chemical composition was analyzed using the differential / expression. Five seconds of exposure to ethanol followed by the 5 min of 9-aminoacridine or α-cyano-4-hydroxycinnamic acid deposition, together with two sets of instrumental settings, were selected for the MALDI TOF MSI experiments. Application of the thin and transparent matrix layers assured good correspondence between the LASER footprints and the preselected regions of interest. Cellular marker / signals coincided well with the appropriate cells. A metabolite databases search using the differentially expressed / produced hits which were consistent with the respective cell types. This study sets the foundations for application of blood smear MALDI TOF MSI in clinical diagnostics and research.
Topics: Adult; Biomarkers; Diagnostic Tests, Routine; Erythrocytes; Healthy Volunteers; Humans; Leukocytes; Male; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Young Adult
PubMed: 33430160
DOI: 10.3390/ijms22020585