A prolonged microscopic observation improves detection of underpopulated cells in peripheral blood smears

Abstract

We evaluated an extended time in the microscopic review in samples in which the potential clinical information could be increased with respect to those that could be achieved with the usual laboratory methodologies. We used samples containing nucleated red blood cells in a small amount and cytopenic samples. For these purposes for each peripheral blood smear, the timing of eye-count differential was increased up to 20 min, regardless of the final number of cells which could be counted. In addition, an automated system for digital analysis of peripheral blood smears was employed and the number of cells counted was brought up to 1000 leukocytes. In both manual and automatic light microscopy extended observation, we obtained more diagnostic information in respect to those with routine or standard methods. Both automated and manual increase systems of the timing for microscopic review are useful tools to find diagnostic information that otherwise would be lost using normal and standard procedures. So, these methods should be used especially when there is a higher pre-test probability for discovery of pathological cells.

How Reproducible Is the Data from Sysmex DI-60 in Leukopenic Samples?

“…Other DM analyzers include Vision Pro (West Medica, Perchtoldsdorf, Austria), EasyCell assistant (Medica, Bedford, MA, USA), Nextslide (Nextslide Imaging, LLC, Cleveland, OH, USA), and so on [ 1 ]. Since DM analyzers were first developed in the 1970s, a number of studies have been reported to evaluate the performance of DM analyzers [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…It is necessary to evaluate the performance of DM analyzers on WBC differentials by focusing on leukopenic samples. Most of previous studies evaluated DM analyzers using pathological samples including some leukopenic samples [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. To the best of our knowledge, however, there has been no study that analyzed leukopenic samples separately as the main subjects to fully evaluate the performance of DM analyzers, including precision [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Mindray BC‐6800 haematological analyser: 3D‐DIFF scattergram usefulness in infectious mononucleosis diagnosis

“…In addition, the known inaccuracy of the microscopic versus instrumental cellular count should be considered, especially in underpopulated cells 18 …”

“…Even considering the known inaccuracy of manual cellular counting in the case of underpopulated cells, mostly, 18 the likelihood of IM increases progressively as the reactive lymphocytes percentage in the PB increases, even more so when the presence of these cells occurs associated with a relative lymphocytosis of more than 50% 28 . Contrary, the diagnostic value assigned to APCs concerns only the qualitative data of their presence, 11,13,14 while their quantification does not seem to have clinical‐prognostic significance.…”

Peripheral blood schistocytes in the acute phase after allogeneic or autologous stem cell transplantation assessed by digital microscopy

“…Vision Hema (West Medica, Austria) is an automated system for digital scanning of stained peripheral blood smears and preclassification of leukocytes, erythrocytes, and platelets . The intervention of an observer is always necessary at the end to confirm allocation of the cells in the proper group and/or to correct allocation by moving cells to the proper group as anticipated by the real‐time digital color‐image of the single cells on the screen.…”