APIH223885221 - CME/CMLE - Blood Cell ID #1 - Identifying Normal Peripheral Blood Cells-APIH223885221

APIH223885221 - Educational Activity

Pdf Summary

The commentary by Karen A. Brown provides an educational overview focused on identifying normal peripheral blood cells, particularly in the context of diagnosing acute myeloid leukemia (AML). This commentary is directed at participants aiming to describe the morphology of normal blood cells, identify polychromatophilic red blood cells (RBCs), and discuss platelet morphology.<br /><br />**Case History:**<br />The case involves a 70-year-old male presenting with shortness of breath and easy bruising, which led to a complete blood count (CBC) test revealing a diagnosis of AML. Key CBC results include low white blood cell (WBC) count (2.3 x 10^9/L), low RBC count (2.90 x 10^12/L), low hemoglobin (8.7 g/dL), and critically low platelet count (13 x 10^9/L).<br /><br />**Normal Blood Cell Identification:**<br />1. **Segmented Neutrophil:** Medium-sized granulocyte with condensed and clumped chromatin; cytoplasm filled with pink, tan, or light violet granules.<br />  <br />2. **Monocyte:** Largest peripheral blood cell; nuclei can be variable in shape with minimal chromatin clumping and blue-gray, often vacuolated cytoplasm.<br />  <br />3. **Eosinophil:** Medium-sized granulocyte with bright red-orange granules; typically has two lobes but can have three.<br />  <br />4. **Polychromatophilic RBC:** Represents reticulocyte stage lacking nucleus but containing residual RNA, indicating a blue-gray appearance. Reveals bone marrow activity in response to anemia.<br />  <br />5. **Normal Platelet:** Originates from megakaryocytes; approximately 1 to 4 µm, light purple or blue-gray, and grainy cytoplasm, sometimes showing a clear granulomere and hyalomere due to slide preparation artifacts.<br /><br />**Acute Myeloid Leukemia (AML):**<br />AML is characterized by an overproduction of immature, nonfunctional myeloid cells in the bone marrow, which may present in peripheral blood. This disorder can result in low counts of normal leukocytes, RBCs, and platelets, leading to complications such as increased infection risk, anemia, and thrombocytopenia. AML is defined by over 20% blasts in blood or marrow and is classified by the World Health Organization based on various parameters including morphology, cytochemistry, genetic studies, and clinical presentation.<br /><br />**Summary:**<br />The case study underscores the importance of cell morphology analysis in diagnosing AML, aided by laboratory techniques and additional testing. Understanding features of normal and pathological cells is crucial for accurate diagnosis and treatment planning.

Keywords

peripheral blood cells

acute myeloid leukemia

AML diagnosis

normal blood cell morphology

polychromatophilic RBCs

platelet morphology

complete blood count

segmented neutrophil

monocyte

eosinophil