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🩸#MorphologyMonday | Case MM260323 onlycells.co.uk/mm260323/ This week’s case features a 58-year-old patient who presented with high fevers, drenching sweats, and jaundice following a hiking holiday in Nantucket, Massachusetts. - Hb: 92 g/L - PLT: 88 x109/L - Bilirubin: Elevated (Unconjugated) - LDH: Significantly raised - Reticulocytes: Raised 👉 Given the patient's travel history, what do you think it could be? #OnlyCells #LabDiagnostics #RedCells #Morphology #BloodFilm #Parasite

🩸#MorphologyMonday | Case MM260216: Southeast Asian Ovalocytosis onlycells.co.uk/mm260216-sao… This week's case showed macro-ovalocytes on the blood film from a patient with Southeast Asian ovalocytosis. #OnlyCells #BloodFilm #morphology #LabDiagnostics #RedCells #Ovalocytes

🩸#MorphologyMonday | Case MM260216 onlycells.co.uk/mm260216/ This week’s case features a patient of Southeast Asian descent, referred to haematology after an incidental finding during a routine pre-surgical workup. Despite being clinically well and having a normal haemoglobin, their blood sample caused a stir in the laboratory. Even without anaemia, the analyser struggled with this sample and gave several alerts. 👉 Given the patient's geographic background what is the most likely diagnosis? 👉 This condition is caused by a specific deletion in a major red cell membrane protein. Do you know which one? 👉 What is the evolutionary advantage of this morphological trait? #OnlyCells #LabDiagnostics #RedCells #Morphology #BloodFilm

🩸#MorphologyMonday | Case MM260202 onlycells.co.uk/mm260202/ This week’s case involves a patient in the ICU with acute liver failure. The FBC results show: - Hb: 67g/L - PLT: 41 - WBC: 8.1 While reviewing the blood film, the biomedical scientist noticed abnormalities in the red cells, but also interestingly some inclusions within the neutrophils. 👉 What are the inclusions? 👉 What do they mean in terms of the patient's prognosis? 👉 What red cell features can you seen? #BloodFilm #Neutrophils #RedCells #haematology #LiverFailure #LabDiagnostics

🩸#MorphologyMonday | Case MM260126 onlycells.co.uk/mm260126/ This week’s case started with a "heads-up" call from the Haematology SpR before the sample even reached the lab. A patient referred from another hospital presented to the ED. FBC Results: - WBC: 319.64 - Hb: 146 g/L - PLT: 205 👉 Question 1: What is the first thing on your radar? What could it be? 👉 Question 2: Why is a G6PD screen so critical in a patient with this specific suspected diagnosis? #OnlyCells #BloodFilm #LabDiagnostics

🩸#MorphologyMonday | Case MM260119: HDFN onlycells.co.uk/mm260119-hdf… The blood film shows increased NRBCs, spherocytes and polychromasia. Given the details of the case it is suggestive of Rh sensitisation following a lack of anti-D prophylaxis. Read more at the link above to understand why anti-Kell HDFN is ruled out in this case. #OnlyCells #BloodFilm #LabDiognostics #neonate #redcells #LabDiagnostics

laboratory diagnosis, accuracy doesn’t start at the microscope it starts from the smear. In haematology, the slide may be small but the information it carries is HUGE. A well-prepared thin blood film is the foundation of accurate diagnosis. CHARACTERISTICS OF A GOOD THIN FILM 1. Smooth, tongue-shaped smear covering about ⅔ of the slide 2. A clean, well-formed feathered edge 3. A perfect monolayer where RBCs just touch without overlapping 4. Even distribution of red cells, white cells, and platelets 5. Cells with preserved morphology no distortion, no artefacts Why is it so important? Thin films are essential for: • Differential white blood cell count • Assessing red cell morphology • Identifying blood parasites, especially malaria species and stages • Confirming subtle haematological abnormalities A poor smear = poor microscopy = questionable results. MedicalLaboratoryScience #Haematology #ThinBloodFilm #BloodSmear #MLS #LabDiagnostics #Microscopy ✅. ❌

🩸#MorphologyMonday | Case MM260119 onlycells.co.uk/mm260119/ Today’s case comes from NICU (neonatal intensive care unit). The neonate has rapid-onset jaundice and a plummeting haemoglobin. The baby's mother is RhD Neg and missed multiple appointments during her pregnancy and so never received anti-D prophylaxis. 👉 Question: Does the film show a "suppressed" marrow or an "active, stressed" marrow response? Look closely at the presence of immature forms. What could the diagnosis be? #OnlyCells #BloodFilm #RedCells #Pregnancy #LabDiagnostics

🩸#MorphologyMonday | Case MM260112 onlycells.co.uk/mm260112/ Today’s case involves a patient with HbE/beta-thalassaemia. Because they are transfusion-dependent, the blood film shows a fascinating "two-tone" picture. Looking closely at the patient’s own red cells, there are distinct "remnants" and inclusions that shouldn't be there. These features tell us exactly what has happened to this patient’s anatomy. 👉 Question: What features do you see and what organ is this patient missing? Comment below with your diagnosis and the features that gave it away! I’ll post the full breakdown and the "reveal" later this week. #OnlyCells #BloodFilm #RedCells #haemoglobinopathy #thalassaemia #LabDiagnostics

🩸#MorphologyMonday | Case MM260105: Prolymphocytes in CLL onlycells.co.uk/mm260105-cll… The results are in for the first case of the year. Many of you correctly identified the cells correctly as prolymphocytes rather than blasts. The initial manual differential overnight flagged these cells as blasts due to their prominent nucleoli. However, a follow-up review confirmed prolymphocytes in a patient with CLL. #OnlyCells #BloodFilm #Haematology #CLL #LabDiagnostics

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🩸#MorphologyMonday | Case MM260105 onlycells.co.uk/mm260105/ A 62-year-old female presented to the ED overnight. The haematology analyser flagged a large "grey" population on the WDF scattergram and a WBC of 38.4×10⁹/L The biomedical scientist on the night shift performed a manual differential and identified a high percentage of the cells as Blasts. However, the clinical picture and the scattergram suggest there might be more to the story. 👉 Question: Do you agree with the initial assessment of "Blasts," or could these be morphological mimics? What else would be on your radar? #OnlyCells #BloodFilm #WhiteCells #LabDiagnostics

🩸#MorphologyMonday | Case MM251201 onlycells.co.uk/mm251201/ This week’s case comes from a 46-year-old male presenting with fatigue, mild shortness of breath, and light-headedness. Routine blood tests showed some abnormalities, prompting a blood film review. FBC Results: - Hb: 104 g/L - RBC: 3.5 ×10¹²/L - HCT: 0.32 - MCV: 91 fL - MCH: 29.7 pg - MCHC: 326 g/L - RDW: 14.2% - WBC: 6.7 ×10⁹/L - Platelets: 228 ×10⁹/L 👉 Question: What cell type can you identify in the image? What conditions do you associate with it? #OnlyCells #LabDiagnostics #RedCells #Morphology #BloodFilm

🩸#MorphologyMonday | Case MM251117 onlycells.co.uk/mm251117/ This week’s case comes from an 84-year-old male who was referred to the haematology team after routine blood tests showed a markedly raised white cell count. Clinically, he reported several weeks of general fatigue but no acute symptoms. He was otherwise well and presented via his GP. The FBC showed: - White cell count: 823 ×10⁹/L (Note: This value exceeded the analyser’s linearity range) - Red cell count: 2.69 ×10¹²/L - Haemoglobin: 84–106 g/L (range reflects correction due to WBC interference) - Haematocrit: 0.306 - MCV: 92.4 fL A blood film was made and images can be seen below. What do you think the diagnosis could be? How do you approach any parameter that exceeds analyser linearity? #OnlyCells #BloodFilm #WhiteCells #LabDiagnostics

🩸#MorphologyMonday | Case MM251110: May Hegglin anomaly onlycells.co.uk/mm251103-mha… ✅ 28-year-old patient ✅ Mild symptoms only: occasional easy bruising, no major bleeding history. ✅ Platelets 62 × 10⁹/L ✅ Blood film: Large platelets pale blue Dӧhle body like inclusions in neutrophils. Diagnosis: May Hegglin anomaly #OnlyCells #BloodFilm #Platelets #Genetics #LabDiagnostics

🩸#MorphologyMonday | Case MM251110 onlycells.co.uk/mm251110/ A 28 year old female was referred to haematology after routine pre-operative blood tests revealed some abnormalities on her full blood count. She reports occasional easy bruising but no significant bleeding history, and is otherwise well. The FBC showed: - Hb: 122 g/L - WBC: 6.8 × 10⁹/L - Platelets: 62 × 10⁹/L - MCV: 89 fL - MCH: 30 pg A blood film was made and can be seen below. What do you think the diagnosis could be? #OnlyCells #BloodFilm #LabDiagnostics

🩸#MorphologyMonday | Case MM251103: Chronic myelomonocytic leukaemia onlycells.co.uk/mm251103-cmm… ✅ 61-year-old patient ✅ Fatigue ✅ FBC; leukocytosis, thrombocytopaenia, anaemia ✅ Monocytosis and monoblasts Diagnosis: Chronic Myelomonocytic Leukaemia (CMML) #OnlyCells #BloodFilm #Haematology #CMML #LabDiagnostics

🩸#MorphologyMonday | Case MM251103 onlycells.co.uk/mm251103/ This week’s case is from a 61-year-old patient referred for haematology review due to persistent fatigue and abnormal routine blood results. The FBC showed: - WCC: 50.4 ×10⁹/L - Hb: 84 g/L - Platelets: 128 ×10⁹/L The analyser also gave a grey scatter plot, which prompted the film review. Further investigations, including immunophenotyping, were performed. Results for these can be seen on the link above. Share your thoughts in the comments 👇 #OnlyCells #BloodFilm #WhiteCells #FlowCytometry #LabDiagnostics