A comparative analysis of peripheral blood smear and rapid diagnostic test for diagnosing malaria gunjan dutta, kiran yadav and jugal kishor aggarwal department of microbiology, saraswathi institute of medical sciences, hapur u. Jun 12, 2016 1 introduction to peripheral blood smear examination. The degree of anisocytosis usually correlates with increases in the rdw or the. Prepare a second smear by repeating steps 35, using the edge of the first slide to spread a drop of blood on the second slide. A thin smear of blood is prepared on following the protocol onto a glass. As basic as it is, pbf is invaluable in the characterization of various. Peripheral blood smear test purpose, procedure, results.
Theres no substitute for a set of human eyes examining a peripheral blood smear under a microscope. Blood films are done to investigate hematological problems involving red blood cells, leukocytes white blood cells, and platelets. A peripheral blood smear, or blood film, is a microscope slide made from a drop of blood for microscopic examination. The smear is stained with wrights stain and performed after the complete blood count is run. Many hematological diagnoses depend upon this procedure and often a definitive diagnosis can be established from the careful examination of the blood film. Section editor lawrence lk leung, md editorinchief hematology section editor disorders of hemostasis and coagulation maureen lyles dambrogio professor of medicine. A comparative analysis of peripheral blood smear and rapid. As a complement to the red cell indices, the blood smear also reveals variations in cell size anisocytosis and shape poikilocytosis. Mix 1 part maygrunwald stain, 1 part wrightgiemsa stain, and 1 part 6.
The book will illustrate the morphologic features on peripheral blood smears of the various disorders and the text will focus on diagnostic criteria, differential diagnosis and modern classification terminology. Scroll left and right to see various peripheral blood components. Place a small drop of blood, or one side about 12 cm from one end. Peripheral blood smear the peripheral blood smear provides important information about defects in red cell production chap.
The interpretation of peripheral blood smears has an important role in the diagnosis of hematologic diseases and is, therefore, part of the education of. Moderate anisopoikilocytosis occasional oval macrocytes, dacrocytes, and elliptoid cells is seen. Peripheral blood smear analysis using image processing. Estimation of platelet count in unstained peripheral blood. A blood smear reveals information about the number and shape of blood cells in the body. An accurate peripheral blood smear report can elucidate a vast spectrum of hematologic disorders, guide further testing, and have a critical impact on patient care.
Peripheral blood morphology for hematological disorders remains a very important diagnostic tool give vital clues for further work up essential in situations where automated cell counter fails due to interferences peripheral blood smear examination a reflex test. The who recommendations for the definition of cytopenia are the same reported in the international prognostic scoring system. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. Platelets also can be identified in the unstained blood smears. The slide is stained with leishmans, and examined under a microscope. A properly prepared blood smear is essential to accurate assessment of cellular morphology. Icsh guidelines for the standardization of bone marrow. Blood films are examined in the investigation of hematological blood disorders and are routinely employed to look for blood parasites, such as those of malaria and filariasis. Shape analysis of the cells in peripheral blood smear for. Interpretation and reporting of coagulation reports.
Fix the slide using pure methanol in a coplin jar for 2 minutes and air dry. A peripheral blood smear is a glass microscope slide coated on one side with a thin layer of venous blood. The best place to examine blood cell morphology is the feathered edge of the blood smear where red cells lie in a single layer, side by side, just barely touching one another but not overlapping. Pdf a microscopic examination of an appropriately prepared and. Peripheral blood smear definition of peripheral blood. A complete blood count cbc and peripheral blood film is a blood panel. Utmedical school at houston, pathology last revision on. Blood smear, alternatively known as peripheral blood smear is a laboratory test in which a thin film of blood is blotted on a microscope slide followed by staining the specimen to permit numerous blood cells to be microscopically observable.
It is often done as part of or along with a complete blood count cbc. Peripheral blood smear test results fully explained a blood smear is basic test that is used to determine diagnostically if there are any abnormalities within the blood. Peripheral blood smear examination linkedin slideshare. Peripheral blood smear examination macroscopic view. Signs of sepsis tips for evaluating a peripheral blood smear. Complete blood count cbc interpretation limitations. Peripheral blood smear are usually examined to investigate hematological problems and occasionally, to look for parasites within the blood. An examination of the blood smear may be requested by physicians or initiated by laboratory staff. The wedge smear the cover glass smear the spun smear the are two additional types of blood smear used for specific purposes buffy coat smear thick blood smears for blood parasites 10. So there is a need in designing an automated system that can identify the shape. Disease caused by any parasite can be diagnosed using the shape of rbcs and wbcs. Most cases of acute leukemia have blasts or immature cells in the peripheral blood.
The wedge smear is a convenient and commonly used technique for making peripheral blood smears. Without delay place a spreader at an angle of 45 from the slide and move it back to make contact with. Peripheral blood smear, preparation, examination, interpretation, reporting, blood cells morphology. The blood smear test is often done to diagnose conditions that are causing. Pdf purpose and criteria for blood smear scan, blood smear. Automated blood cell counters have largely replaced the manual method. Peripheral blood smear analysis is a common practice to evaluate health status of a person. Occasionally, patients present with no peripheral blasts aleukemic leukemia. The elements seen, altogether, are not representative of normal peripheral blood, but are portrayed for learning and identification purposes. The role of the peripheral blood smear in the modern haematology laboratory automated haematology cell counting the laboratory practice of haematology has evolved tremendously over the past few decades with automated analyser generated complete blood counts cbc having fully replaced the original manual individual parameter assay methods. P, india corresponding author a b s t r a c t malaria.
The test request form must be completed with patient history, including pertinent clinical information and physicians name and telephone number. The red cells are decreased in number and are normochromic and macrocytic. When the first automated hematology analyzers appeared in clinical laboratories in the 1960s, they ushered in a welcomed workflow change for bench technologists. A blood smear is a blood test that gives information about the number and shape of blood cells. A phlebotomist, a person specifically trained to draw blood, first cleans and sterilizes the injection site with an antiseptic. Peripheral blood smear test results fully explained hrf. Peripheral blood test your knowledge below is a slide at high magnification under an oil immersion lens. The examination and interpretation of peripheral blood smears is an important component of clinical pathology. The peripheral blood film remains a very useful tool in hematological assessment. The peripheral blood film pbf is a laboratory workup that involves cytology of peripheral blood cells smeared on a slide. The white blood cells are decreased in number and consist mostly of. Complete blood cell count and peripheral blood film, its.
Seed haematology the role of the peripheral blood smear. Water absorbed from the humid air into the alcohol based stain. The final interpretation requires the integration of peripheral blood, bone marrow aspirate and trephine. Comparison of manual versus automated data collection. The white blood cells are decreased in number and consist mostly of blasts 41% as reported on the differential. However, all abnormal platelet counts are verified in leishmans stained peripheral blood smear. The focus will be on the three primary types of cells that can be found within the blood. Synoptic reporting system for peripheral blood smear. Many disorders such as malaria, anemia, leukemia, thrombocytopenia, sickle cell anemia etc. Detecting disease states or syndromes of the white blood cells, red blood cells, or platelet cell lines of a patients peripheral blood. Introduction to peripheral blood smear examination.
Hematopathology consultation, peripheral smear labcorp. Preparation of smear there are three types of blood smears. Healthcare professionals have been challenged in evaluating peripheral blood smears essentially since the invention of the microscope. Attention to detail in slide preparation, staining and standard criteria for cell estimates, morphology and differential reporting enhance the value of results provided to the physician. Signs of sepsis tips for evaluating a peripheral blood. Examination of the peripheral blood smear is an inexpensive but powerful diagnostic tool in both children and adults. A complete blood count cbc, also known as a full blood count fbc, is a medical laboratory. Second, appearance of the organism in peripheral blood, especially in cats, can be. Careful examination of the peripheral blood smear is of key importance to the diagnosis of leukemia. Although advances in automated technology have made the examination of a peripheral blood smear by a physician seem less important, the technology is not a completely satisfactory replacement for a blood smear interpretation by a trained medical professional who also knows the patient. May 01, 2015 peripheral blood smear examination macroscopic view. When studying the blood smear slide, pay close attention to nuclear characteristics, staining patterns, and cell diameter remember that erythrocytes are usually 78 m in diameter. Reports of malignant cells in a routine blood smear have been extremely rare. Abundant information can be gathered from the blood smear, including subtle changes such as toxic changes in the neutrophils, hemic parasites in the erythrocytes or low numbers of neoplastic cells or mast cells that may help to make a diagnosis.
Why do we still need to evaluate peripheral blood smears. A blood filmor peripheral blood smearis a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically. There, the lab technician looks at it under a microscope. Seed haematology the role of the peripheral blood smear in. Peripheral blood film or peripheral blood smear or peripheral smear examination forms an important and basic lab investigation for diagnosing a number of hematological blood disorders. The examination of a peripheral blood smear is one of the most informative exercises a physician can perform. The blood sample is sent to the lab where a drop of blood is spread thinly onto a glass slide and it is then treated with a special strain. A blood film or peripheral blood smear is a thin layer of blood smeared on a microscope slide. Peripheral blood smear test is ordered as part of a general health exam to help diagnose many illnesses it helps diagnose if red blood cells, white blood cells and platelets are normal in appearance and number. Microscopic examination of the peripheral blood is used to supplement the information provided by.
In conclusion, examination of the peripheral blood smear is an essential component of a cbc. Peripheral blood smear definition of peripheral blood smear. Assessment of platelet count is an important diagnostic parameter in haematology. This program has a knowledge base containing 150 peripheral blood smear report templates covering a wide spectrum of pathologic findings. Oct 18, 2016 preparation of smear there are three types of blood smears. The use of glass slides for desi profiling of blood samples leaves the opportunity to combine it.
Smears made from edtaanticoagulated blood should be made. A variety of methods are available for preparing and staining blood smears, the most common of which are discussed in this atlas. Tips for evaluating a peripheral blood smear for possible sepsis by scott warner, mltascp in an era of point of care testing and increasing automation, its nice to be needed. Investigation of abnormal peripheral blood smear morphology suggestive of bone. It is not appropriate to use the same edge of a slide for more than a single film. Teaching the clinical interpretation of peripheral blood smears to a. Use the oil immersion lens to identify each cell type. Peripheral blood smear synonyms, peripheral blood smear pronunciation, peripheral blood smear translation, english dictionary definition of peripheral blood smear. Peripheral blood smear test procedure the blood smear test is a simple procedure in which your health care provider draws a blood sample from the vein in your arm. A synoptic reporting system for peripheral blood smear. We developed a webbased synoptic reporting program to assist in peripheral blood smear reporting. The smear offers a window into the functional status of the bone marrow, the factory. Malignant cells in a peripheral blood smear report of a.
The examination of blood films stained with wrights stain frequently provides important clues in the. The slides should be dried as quickly as possible to prevent. Atlas of hematology and analysis of peripheral blood smears. Diagnosis and classification of myelodysplastic syndrome. Peripheral blood or potassium edta anticoagulated blood 12 mg edta1 ml blood may be used.
In some ways it is becoming a lost art but it often provides rapid, reliable access to information about a variety of hematologic disorders. Color atlas and instruction manual of peripheral blood. Users can access this system on the internet and select. Highquality, bevelededge microscope slides are recommended. In nutshell, the value of peripheral blood smear in assessing morphology and differential counting of blood cellular elements cannot be downplayed. Introduction to peripheral blood smear examination oncohema key. Although advances in automated technology have made the examination of a peripheral blood smear by a physician seem less important, the technology is not a completely. Author david s rosenthal, md professor emeritus harvard medical school. This book will be a fullcolor atlas of both benign and neoplastic proliferations in the blood. Or, the blood may be examined by an automated machine. This essential guide can help readers identify blood type cells, which are difficult to categorize, and explains the morphologic characteristics of peripheral blood cells in detail. The examination of the peripheral blood smear is an important basic hematological procedure. Peripheral blood smear procedure and interpretation.
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