ISSUE28ISSUE

September
2022

This issue
Last Month’s Slides P.1
Monthly Digital Case study P.1
Platelets P.2-3
Cell Quiz P.2

Last Month’sSlides
Slide 1
See case study on right.

Slide 2Monthly Digital Case Study

Nothing to report.

Presentation September 2022, Slide 1

Slide 3

FBC Results

Nothing to report.

WBC 23.2 (10^3/mm3)
RBC 3.7 (10^6/mm3)
HGB 11.0 (g/dL)
HCT 34.1 (%)
MCV 9330.0 (fL)
MCH 32.1 (pg)
MCHC (g/dL)
PLT (10^3/mm3)
Neutrophils 81.6 %Lymphocytes 9.6 %Monocytes 2.4 %Eosinophils 0.0 %Basophils 0.8 %Blasts 0.8 %Slide 4
Nothing to report.

Slide 5
Nothing to report.

Slide 6
Nothing to report.

Slide review

Normoblast/Erythroblast

Blast

Large Platelets

01 September 2022
Male (70 years old).
Perioperative resuscitation unit. Anisocytosis (RDWsd at 66 fL). Microcytes(+).
Macrocyte(+). Myelemia. Thrombocythemia. Presence of macroplatelets.
Expert's comments : Look for a myeloproliferative syndrome if the thrombocytosis
persists.

Platelet morphology inperipheral blood - An
overview of laboratory
findings

Monthly Morphology
QuizLook closely at this red cell:

Introduction
Platelets are cell fragments circulating in the peripheral that are involved insecondary haemostasis. Aggregated platelets, platelet polymorphism, platelet
satellitism and the presence of platelet precursors, megakaryocytes, in theperipheral blood are useful indicators of a variety of conditions.

Platelet production
What is unusual about it andwhat could this indicate?

Platelets are produced in the bone marrow by fragmentation of the tips ofcytoplasmic extensions of cells, called megakaryocytes. Each cell produces
approximately 1000 to 5000 platelets. They are released into the blood stream
through the endothelium of the vascular niches of the bone marrow.
There is a 10-day cycle for the production and release of platelets:

Last month’s cells:

What is the parasite (Fieldstain)?
a) P Ovaleb) Babesia Divergensc) P Malariae

Answer:
The blood film shows The cellis from a patient with red cell
parasitised by Babesia
Divergens and shows aMaltese cross form which if
present is diagnostic ofBabesia.

Platelet aggregates
Platelet aggregates are very common and can give rise to falsely low platelet
counts and occasional interference with other parameters. They can be causedby slow or difficult venepuncture but in some individuals, platelets may besensitive to EDTA anticoagulant and invariably clump when blood samples aretaken. In these instances, a sample taken into tri-sodium citrate can give a
correct result after correction for anticoagulant dilution factor.

Platelet Satellitism
Platelet satellitism (seen right) is a rare
phenomenon in EDTA blood where theplatelets congregate around a white cell(usually a neutrophil).

QSP 2.0
Available as a single use
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which allows up to 50
concurrent users.
To find out more, contact us.

It is generally considered to be an artifact, but it
has been observed in some conditions including
lymphoproliferative disorders, lupus, vasculitis
and liver disease but a cause has not been
established.

Bibliography

Giant platelets

Hoffbrand’s Essential
Haematology 7th edition
Wiley Blackwell

The presence of giant platelets may indicatethat there is increased platelet production, as
younger platelets tend to be larger. It is also
associated with Idiopathic Thrombocytopaenia
Purpura (ITP). In this case, the platelets may not
function correctly as they are unable to stick to
the injured blood-vessel wall.
Giant platelets also occur in hereditary platelets
disorders, such as Bernard-Soulier Syndrome.

Editorial Team
Kelly Duffy
Andrew Fisher

Megakaryocytes
Megakaryocytes are normally not seen in theperipheral blood and their presence isindicative of bone marrow, such as
Myelodysplastic
Symdrome,
Myeloid
Leukaemia, Polycythaemia Rubra Vera andmyelofibrosis.
Megakaryocytes
intheperipheral blood are often ‘bare’ – ie. withminimal cytoplasm (see right).

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