ISSUE

14ISSUE

June
2021

This issue
Last Month’s Slides P.1
Monthly Case study P.1
Platelets & counting methodology P.2
Monthly Quiz P.2
Platelets & counting methodology P.3
Biomedical Science Day 2021 P.3

Last Month’sSlides
Side 1
See case study on rightMonthly Digital Case study
May 2021

Slide 2
Neutrophilia, monocytosis,presence of blasts. ?CMML/AML

Slide 3
Erythroblastosis, Basophilia,
platelet anisocytosis.
? Myeloproliferative

Slide 4
Nothing abnormal noted

Slide 5
Nothing abnormal noted

Slide 6

Presentation
Female (39 years old)

FBC Results
WBC4.57 (10^3/mm3)RBC
2.74* (10^6/mm3)HGB
9.6* (g/dL)
HCT
26.8* (%)
MCV
98 (fL)MCH35 (pg)
MCMH 35.9 (g/dL)
PLT
196 (10^3/mm3)
Neutrophils 74.9
Lymphocytes 8.3
Monocytes 5.6
Eosinophils 1.9
Basophils 6.5
Anaemia assessment

Anisocytosis

Nothing abnormal noted

Slide review
Lymphopenia.
Presence of target RBCs.
Expert comment:
There seems to be spherocytes(maybe an aspect of dimorphic
red cell population).
Reticulocytes result ?

Target Cells

Webinar on morphology

Platelets and counting methodology

Our recent webinar on “AnIntroduction toMorphology” which includes
a demonstration on how touse QSP in training is now
available on demand

Platelets are small (1.5 – 3 um in diameter) anucleate cells which can beseen in the spaces between the red cells. Platelets contain fine azurophilic
granules. Down the microscope platelets can appear quite mundane andboring, but they are packed full of important granules that are essential forhaemostasis and wound healing.

Watch it here

Platelets (denoted by box)

Monthly QuizLook at the slide and choose
the correct red cell from themultiple choice below:A) Spur Cell

2 Platelets greater magnification

Platelet are formed in the cytoplasm of Megakaryocytes in the bonemarrow through a complex process including endomitotic development of
the Megakaryocyte until finally proplatelets are formed which extend intosinusoidal blood vessel where platelets bud off and enter the blood stream.
The normal adult range for platelet is 150 - 400 x10^9/L with a low platelet
count being a cause for concern due to the increased likelihood ofexcessive bruising and or blood loss.
Platelets are essential in primary haemostasis and rapidly form a loose
platelet plug to stop blood loss at the site of blood vessel injury. Exposureof the subendothelial tissue causes the adhesion of platelets to the damage
due to the lack of production of platelet function inhibitors. Plateletactivation then occurs causing the platelets to release potent activation
factors such as ADP which leads to further recruitment and activation ofplatelets. Activated platelets bind fibrinogen which acts as bridge between
platelets causing platelet aggregation. Exposure of tissue endotheliuminitiates the plasma coagulation cascade which together with theaggregated platelets forms a firm clot.

B) Target Cell RBCC) Tear drop cellD) Sezary Cell

The normal Mean Platelet Volume (MPV) is 7.4 – 12 fL with immatureplatelets having a higher MPV. Platelets and red cells are counted using
aperture impedance technology with Platelets and red cells separated by amoving threshold based on the volume of the cell. Microcytic red cells or
red cell fragments may interfere with the platelet count as they may sharethe same volume range of platelets and in such cases the analysers detects
their presence around the threshold area.
Platelet/RBC threshold
RBC
Platelets

Diagram to show RBC interference in the area of the Platelet/RBC thresholdIf such instances occur on a Yumizen H2500 analyser, an optical platelet countwill be automatically reflexed and reported alongside the aperture impedancecount.
In the optical platelet count method the cell is passed through the same flow
cell as used in the LMNE channel for the WBC differential. Since an optical lightsource is used, rather than a laser, it is possible to measure the opticalextinction which includes both conventional light absorption and light scatter.
The optical extinction enables a better understanding of the internal
components of the cell and allows discrimination of the type of cell with thesame volume.
The optical extinction is plotted against the volume of each cell and a moving
threshold separates the red cells from the platelets (yellow).

QSP 2.0
Available as a single
use license and asite license whichallows up to 50
concurrent users.
To find out more,contact us

Bibliography
Medical Laboratory
Haematology

Optical Extinction

HORIBA Medical
Yumizen H2500 user
manualEditorial Team
Kelly Duffy
Andrew Fisher
VolumeAn additional red cell count is performed in the RBC/Plt chamber using
aperture impedance. The optical platelet count is calculated using the ratio ofPlts/RBC from the optical platelet count multiplied by the RBC from theaperture impedance.

About us

Biomedical Science Day 2021
The Biomedical Science Day 2021 was celebrated on 24th June. A day to say a big
THANK YOU to the Biomedical Scientists, Clinical Scientists and laboratory staff out
there who are in the heart of healthcare, by performing vital analyses and are
involved in over 70 per cent of diagnoses.

HORIBA UK Limited
Kyoto Close
Moulton Park
Northampton, UK
NN3 6FLHORIBA Medical
Parc Euromédecine,
390 Rue du Caducée,
34790, France
www.horiba.com/medical