CSF Sample Shows Tumor Cells

You answered the question incorrectly.
A cerebrospinal fluid sample was taken from an inpatient with severe neurological
symptoms. The image on the right shows a field from a cytospin preparation from this
patient's fluid. What findings are present in this field?
The correct answer is highlighted below
Blast cells
Mesothelial cells
Choriod plexus clump
Tumor cells
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This is a cytospin from the CSF of a patient with disseminated retinoblastoma

demonstrating a large tumor cell clump with an occasional mitotic figure. Tumor cells
should be reported for this sample. This sample should be sent for hematologist or
pathologist review prior to reporting these findings.
You answered the question correctly.

Which of the white cells indicated by the arrows in the image is normally the most
numerous cell type found in peripheral blood?
Cell "b" = neutrophil

Cell "a" = lymphocyte
Cell "a" = segmented neutrophil
Cell "b" = lymphocyte
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Cell A in this image is a segmented neutrophil. Neutrophils are normally the most
abundant cell type found in the peripheral blood; usually 60-80% of the total white
blood cells.

Identify the nucleated blood cell:
Lymphocyte
Neutrophil
Band form
Monocyte
Eosinophil
Basophil
The inclusions that are seen in the white cell indicated by the arrow in this image are
characteristic of which of the following conditions?
Chediak-Higashi anomaly
Infection
Pelger-Huet anomaly
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Chediak-Higashi anomaly is characterized by the presence of large, fused granules in
the cytoplasm of white blood cells and some tissue cells. It is an autosomal recessive
disease associated with albinism, decreased immune function, and neurological
complications.
The nucleated red blood cell and myelocyte photographed here were found on
scanning of a peripheral blood smear. In context they are suggestive of metastatic
carcinoma to the bone marrow.
True
False
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The presence of scattered normoblasts and myelocytes in the peripheral blood

indicates disruption of the normal bone marrow mechanism of releasing only mature
cells into the peripheral blood. Such findings should lead to an investigation of
metastatic disease, particularly breast or prostate. Infectious granulomas in the bone
marrow or solid areas of myelofibrosis may also lead to the release of immature
cells(leukoerythroblastosis). Extramedullary hematopoiesis though rare in the spleen
or liver, may also be considered.These hematopoietic sites do not possess the ability
to release only mature blood cells. Scanning peripheral blood smears rapidly yet
thoroughly is a valuable skill.

The abnormal cells indicated by the arrows in this illustration are indicative of:
Sickle cell disease

Vitamin B12 deficiency
Severe burns
Iron deficiency
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Cells seen here are sickle cells or drepanocytes.
Question Difficulty: Level 2

A complete blood count is performed. The white blood cell count is elevated and a
manual differential is required. The technologist evaluates the red blood cell
morphology and finds it "Normal." Which of the following histograms would
represent this red blood cell morphology?

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The normal red blood cell histogram is a single peak centered over the average normal
size for red blood cells.
A wide red blood cell histogram represents a mixed population of cells.
The red blood cell histogram with a single peak centered over the a value that is
greater than average normal size for red blood cells represents a population rich in
macrocytes.
A histogram with a double peak represents two distinct populations of cells.


What morphological change is present in this image?
Hypersegmentation of the nucleus

Hyposegmentation of the nucleus
May-Hegglin/Dohle body
Toxic granulation
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The morphology indicated by the cell in this image is hyposegmentation. This

neutrophil, would normally have 3-5 lobes; however, in this case the nucleus has not
segmented. This morphology is typical of a homozygous-inherited Pelger-Huet
anomaly.


A known case of hemolytic disease of the newborn (HDN) is presented in the image
on the right. Many different cellular morophologies are present. Apart from the
obvious anisocytosis (microcytes and macrocytes), which additional red blood cell
morphologies are worth reporting?
The correct answers are highlighted below
Nucleated red blood cells

Spherocytes
Schistocytes
Polychromatophilic cells
Howell-Jolly bodies
Target cells
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Notice the size variation (anisocytosis) of the erythrocytes on the infant's peripheral
smear. There are normal-sized red blood cells, microcytes, spherocytes, macrocytes,
and nucleated red blood cells present on this smear. Red cell variations are expected
findings in healthy neonates, but the variations here are exaggerated. There are
spherocytes, Howell-Jolly bodies, nucleated red blood cells, and polychromatophilic
cells present in this image. A high (3-7%) reticulocyte count is not unusual during the
first three or four days after birth, however, the bone marrow in this infant is
proliferating vigorously in response to the ongoing hemolysis associated with this
condition.
Most of the red blood cells in this field could be described as:
Hypochromic
Hyperchromic
Normochromic
Polychromatophilic
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This peripheral smears depicts many hypochromic red blood cells. The central pallor
of a red cell should typically not exceed more than one-third of the red cell diameter.
In these cells, the central pallor takes up most of the cell, indicating a decreased
amount of hemoglobin inside of the cells. Patients displaying this morphology are
.often classified as anemic

Lymphocyte
Neutrophil
Band form
Monocyte
Eosinophil
Basophil

Identify the large multinuclate cell found in this cerebrospinal fluid cytospin field.
Mesothelial cell
Tumor cell
Multinucleate histiocyte
Macrophage
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This multinucleate giant cell is a histocyte.
This Prussian Blue stain shows a ringed sideroblast.
True
False
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The image in this question shows a ringed sideroblast. Ringed sideroblasts are red
blood cell precursors which have an abnormally increased amount of iron surrounding
their nucleus. Iron stain, such as Prussian blue, is used to stain the iron in these cells.
Ringed sideroblasts are associated with sideroblastic anemia, myelodysplastic
syndromes, and other leukemic and genetic conditions.
A ten-year-old boy came to a physician's attention because of recent jaundice and

icteric sclerae after taking the medication Primaquine before a trip to Africa. The
immediate laboratory work revealed: Hct 24%(normal 36%-47%), MCV 79.5 fl
(normal 78-95fl),RDW 13%(normal 11.5-15.0%).
His blood smear findings are reflected in the images to the right. The upper image is a
Wright-Giemsa stained smear while the lower is a supravital-stained smear. Which
condition should be considered for this patient when analyzing his symptoms, history,
and laboratory results?
G6PD deficiency
Pyruvate kinase deficiency
Iron deficiency anemia
Megaloblastic anemia
Feedback
Note particularly the spherocytes in the upper image to the right. Some resemble a
half-blister with the other half of the cell containing solidly-staining hemoglobin.
These are called eccentrocytes. When present, along with a suspicious patient history,
they should trigger an evaluation for G6PD deficiency.
Upper image: The blue arrows in the upper photomicrograph are directed toward
solid-staining spherocytes in which the cell membrane is beaded by inclusions
wrapped within the cell membrane, suggesting the remains of denatured hemoglobin.
Included on the smear is a target cell, several acanthocytes, a smudge cell, and a few
schistocytes.
Lower image: This is a supravital staining of the affected red blood cells, confirming
the presence of Heinz bodies, a key diagnostic feature of this condition.
Pyruvate kinase deficiency is associated with a normocytic, normochromic anemia
with poikilocytosis and anisocytosis, but Heinz bodies are not found in this condition.
Iron deficiency anemia is assoicated with a microcytic, hypochromic anemia and is
not associated with the presence of Heinz bodies. Finally, megaloblastic anemia is
considered a macrocytic, normochromic anemia associated with abnormal red blood
cell development. This condition is also not associated with the presence of Heinze
body inclusions
What is the best description of the phenomenon seen in this illustration?
Rouleau formation
Cold agglutination
Rosette formation
Monocyte activation
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The image shown in this question is depicting a rosette formation. Here the red blood
cells are surrounding and adhering to the outside of the white blood cell.

Observe the peripheral blood smear image to the right. Pictured are scattered
acanthocytes, echinocytes, target cells, spherocytes, and schistocytes. The condition in
which each of these atypical RBC's may be found in varying numbers in the same
peripheral blood smear is most likely:
Hemolytic anemia
Postsplenectomy syndrome
Disseminated intravascular coagulation
Thalassemia minor
Feedback
The intended response is postsplenectomy syndrome. The red blood cell

morphologies seen in the image may be produced in small numbers in normal people;
however, the spleen is efficient in removing these from the circulation so that they are
not found in a peripheral blood smear of a disease free, untreated patient. However,
following splenectomy, this removal function is no longer in place and scattered
acanthocytes, echinocytes, target cells, spherocytes, and schistocytes remain in the
circulation.
The white blood cell indicated by the arrow is representative of the atypical white
blood cell associated with infectious mononucleosis.
True
False
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The intended response is false.
This is a monocyte with prominent cytoplasmic vacuoles, characteristically seen in a

variety of toxic states. The cell shown is a true monocyte and not an atypical
lymphocyte; which is the white blood cell associated with infectious mononucleosis.

Identify the object contained in the cell in this illustration indicated by the arrow:
Auer rods
Dohle bodies
Heinz bodies
Cabot ring
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Cabot rings may be found in megaloblastic anemias, thalassemia, and following

splenectomy. They appear as ring shaped, loop shaped or figure eight shaped
structures.
The cell indicated by the arrow in this illustration is called:

Metamyelocyte
Monocyte
Band
Segmented neutrophil
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The cell in the image is a band neutrophil. Band neutrophils have a characteristic U-
shaped nucleus with a more loose chromatin pattern than their more mature neutrophil
counterparts.
A patient is admitted to the emergency room with severe lethargy, glossitis, and
muscle
dysfunction. After the physician orders a complete blood count with differential, the
hematology technologist observes cells matching the image to the right. Which
condition is most consistent with the clinical and laboratory findings?
Sickle cell anemia

Megaloblastic anemia
Aplastic anemia
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The patient's clinical symptoms and laboratory picture are most consistent with iron
deficiency anemia. The cells appear hypochromic with a marked poikilocytosis and
anisocytosis. Sickle cell, megaloblastic, and aplastic anemias do not have the clinical
symptoms or peripheral smear characteristics that this case displays.
A 12-year-old child presents with jaundice and scleral icterus. The image to the right
captures a representative section of the peripheral blood smear. Which of the
following are significant findings that should be included on the report?
Burr cells
Ovalocytes
Spherocytes
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The intended responses are spherocytes (microcytes without central pallor), indicated
by the blue arrows and polychromatophilic cells (blue-gray staining cells), indicated
by the red arrows. Polychromatophilic cells are immature erythrocytes (reticulocytes)
released from the bone marrow early. The bone marrow rapidly releases young red
blood cells in response to severe hemolysis. These young red blood cells
(polychromatophilic cells or reticulocytes) enter the circulation before completing
their normal 24-hour maturation cycle.
In addition, there are a few burr cells present as well as an ovaloctye, but these are not
significant findings according to most reporting systems. However, the spherocytes
and polychromatophilic cells should be reported, as they are significant, even in small
numbers.

The misshapened "spiked" erythrocytes included in the photograph may be found in

each of the following conditions EXCEPT:
Cardiac valve prosthesis

a-beta-lipoproteinemia
Disseminated intravascular coagulation
Extensive burns
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The intended response is "B". The distorted erytrocytes illustrated in the photograph
are called schizocytes, or schistocytes. They are formed when fibrin is deposited
within the vasculature and red cells must find their way around them as occurs in
disseminated intravascular coagulation. These aberrant red cells may be secondary to
trauma to red cells as they pass through prosthetic valves and they may accompany
extensive burns, among other disorders. A-beta-lipoproteinemia is a condition
associated with acanthocytes rather than schizocytes. Acanthocytes have less red cell
distortion, with spikes much shorter and more delicate, and the majority of the red
cells being effected.

Select the choices below that should be included in this pleural fluid cytospin report.
Lymphoma cells
Lymphocytes
Mesothelial cells
Neutrophils
Macrophages
Hemophagocytosis
Feedback
This is a reactive effusion in a patient with refractory Non-Hodgkins lymphoma. The

cells that should be included in the report are:
 Lymphoma cells (A)

 Lymphocytes (B)
 Neutrophils (C)
 Macrophages (D)
 One macrophage shows hemophagocytosis (D-1)

An 8-year old girl's peripheral blood smear is shown in the image on the right. The
condition present is most likely homozygous sickle cell anemia.
True
False
Feedback
Hemoglobin electrophoresis is necessary to document the diagnosis, however, the

presence of numerous target cells and sickle cells suggests HbSS with full blown
sickle cell anemia.
Target cells may not be present at all with HbSA. HbC disease cannot be eliminated
without electropheresis. Hemoglobin F is protective against symptoms of sickle cell
anemia in infants with sickle cell disease.

Please identify the illustrated leukocyte.
Neutrophil
Monocyte
Lymphocyte
Basophil
Eosinophil
Platelet
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The cell shown in the image is a monocyte. Monocytes typically have a loose/lacy
chromatin pattern in the nucleus with plenty of pale blue cytoplasm. It is not
uncommon to see vacuoles in the monocyte cytoplasm.

Identify the object contained in the cell in this illustration indicated by the arrow:
Cabot rings
Malaria
Howell-Jolly bodies
Pelger-Huet anomaly
Feedback
Howell-Jolly bodies are remnants of nuclear DNA - they may be seen after
splenectomy, in hemolytic anemia, and in megaloblastic anemia

A physician orders a peritoneal lavage on a patient who complained of fever and
abdominal pain following an automobile accident. The fluid is analyzed in the
laboratory. How should the sample shown in the image to the right be reported?
Neutrophils
Intracellular bacteria
Mesothelial cells
Lymphocytes
Extracellular bacteria
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In this image, there are intracellular bacteria inside of the neutrophils; therefore, both
of these observations should be reported. In addition, extracellular bacteria is also
noted in the field. This finding should be included as well.

A peripheral smear with red blood cells photographed in a typical field was submitted
for review. Which of the following conditions might be eliminated because of the red
blood cell population found here?
Severe liver disease

Hemoglobinopathy
Beta thalassemia
None of the above
Feedback
Target cells have a central area of hemoglobin surrounded by an area of pallor and a
band of hemoglobin at the periphery of the cell. Their presence in disease is diverse,
including all of the above conditions as well as post-splenectomy, other thalassemias,
and occasionally in iron deficiency anemia.
In target cells, the surface area to volume ratio of the cell is increased. In a sense,
target cells may be viewed in morphological contrast to spherocytes whose
hemoglobin content fits tightly within the cellular membrane. Target cells may be
macrocytic or normocytic.

Match the letters representing the peripheral white blood cells with the most likely
clinical conditions in which the cell would be present in increased numbers.
Your answers are on the left. The correct answers are on the right and highlighted.
Chediak-Higashi anomaly Frame A

Parasitic infections Frame B
Chronic metabolic conditions, such as diabetes mellitus Frame C
Severe inflammatory states Frame D
Feedback
Frame A shows a white blood cell containing the intracytoplasmic inclusions

characteristic of Chedak-Higashi anomaly. Ocular and cutaneous albinism, increased
susceptibility to pyogenic infections, abnormal granules in neutrophils, and a bleeding
tendency are all prominent findings in Chediak-Higashi anomaly.
The cell in Frame B is an eosinophil, which may be seen in increased number with
invasive parasitic infections.
Frame C is a basophil. Basophils may be increased in the peripheral blood in patients
with chronic metabolic conditions, such as diabetes mellitus.
Frame D is a neutrophil with toxic granulation and vacuoles, toxic changes that may
be observed on the peripheral smear in cases of severe inflammation.

The hemoglobin electrophoresis patterns that are shown on the right include controls
for A, S, and C; and A and F above and below the patient results. (NOTE: ASC and
AF are simply labels for the controls and do not indicate order of migration.) The
patient was tested in duplicate and the results are in lanes 5 and 6. The patterns on the
left are from an alkaline hemoglobin electrophoresis and the patterns on the right are
from an acid electrophoresis. These are results from the same patient.
The patient lanes displayed in these hemoglobin electrophoresis patterns are

consistent with what diagnosis?
HbSA
HbSD
HbSS
HbS/HPFH
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The patient lanes show one heavy band of hemoglobin in the "S" position on both
alkaline and acid electrophoresis.

Sickle cells along with target cells, as shown in this image, confirm a diagnosis of
sickle cell disease (HbSS).
True
False
Feedback
The statement is not true. Although both sickle cells and target cells are present in this
blood smear, hemoglobin electrophoresis is necessary to establish the underlying
condition.
A double heterozygous condition known as Hemoglobin SC disease also exists where one beta chain
carries the mutation for HbS and the other beta chain carries the mutation for HbC.
In addition, HbS can be present with thalassemia.
Sickle cell anemia can also demonstrate hereditary persistance of fetal hemoglobin (HbS/HPFH).
Other rare HbS combinations are also possible and need to be determined through hemoglobin
electrophoresis or other appropriate methods.


Which of the following conditions might give rise to the red cell abnormality depicted
here:
Hemolytic anemia
Leukemia
Infectious mononucleosis
Feedback
The fine basophilic stippling seen here may be due to reticulocytosis secondary to
hemolytic anemia. Coarse basophilic stippling is usually associated with
megaloblastic anemia, thalassemias, and lead poisoning.

What are the abnormal red blood cells (RBCs) indicated by the arrows that may be
suggestive of an individual possessing the Rh null phenotype?
Sickle Cells
Target Cells
Schistocytes
Stomatocytes
Feedback
These are stomatocytes. Stomatocytes have a "coffee bean" or "kissing lips"

morphology on the peripheral smear as shown in this image. They are characterized
by a decrease in the ratio of surface area-to-volume. Most cases are due to alteration
in permeability, leading to an increase in red cell volume.
Individuals who possess the Rh null phenotype have osmotically fragile red cells,
which take the form of stomatocytes. Individuals with this phenotype tend to
experience varying degrees of chronic hemolytic anemia.

The red blood cell inclusions noted in the peripheral smears to the right are called:
Howell -Jolly bodies

Basophilic stippling
Malarial ring forms
Pappenheimer bodies
Feedback
The intended response is pappenheimer bodies, also known as siderotic granules. In

Wright-stained smears the inclusions stain blue. The granules stain positively with the
iron stain, as shown in the lower image. These inclusions are larger than the fine
granules seen in basophilic stippling. Howell-Jolly bodies are larger, spherical, non-
refractile inclusions, and malarial ring forms are larger and distinctly ring-shaped,
occupying up to 1/5 of the red cell diameter.

The image on the right is a representative field from a peripheral blood smear. Which
of the following MCV values correlates best with the peripheral blood picture?
68 fL
82 fL
105 fL
Feedback
The cells that are observed in the peripheral smear are larger than normal red blood
cells. Which is confirmed by the fact that the majority of the red cells are larger than
the nucleus of the lymphocyte in the field. These red cells are classified as
macrocytes. The reference interval for MCV is 80-100 fL. An MCV value above 100
fL correlates with a finding of macrocytes.

What is the name of the structure that is indicated by the arrow in the image?
Döhle body
Auer rod
Barr body
Feedback
The morphology noted in the image is a Barr body. A Barr body is a small appendage,
usually round, connected to the nucleus by a chromatin strand. Barr bodies are usually
observed only on peripheral blood smears from females.

The presence of erythrocytes with altered morphology (as indicated by the arrows in
the image to the right) has a close association with each of the following conditions
EXCEPT:
Disseminated intravascular coagulation (DIC)

Severe burns
Bone marrow metastasis
Thrombotic thrombocytopenic purpura (TTP)
Feedback
The intended response is bone marrow metastasis. Schistocytes are less likely present
in a peripheral blood smear from a patient with bone marrow metastasis. Nucleated
RBCs, teardrop forms, and ovalocytes are more likely findings.
Atypical, fragmented, and triangulated erythrocytes devoid of central pallor

(schistocytes) are found in conditions of erythrocytic membrane damage. These
changes follow as red blood cells are forced through a dense fibrin mesh of clot
formation. DIC, severe burns, and TTP are all associated with fragmented red cells.

The red cells in this illustration exhibit which of the following abnormal erythrocyte
shapes:
Teardrop cells
Blister cells
Stomatocytes
Ovalocytes
Feedback
Teardrop cells appear as pear shaped red blood cells. They may be seen in
myelofibrosis with myeloid metaplasia.


Identify the cell in this illustration indicated by the arrow:
Metamyelocyte
Lymphocyte
Monocyte
Feedback
Lymphocytes are generally the smallest normal WBC seen in the peripheral blood.

The reason for varied red blood cell morphologies after splenectomy is due to the
spleen's pitting, culling, and filtering capabilities. Without the spleen, the abnormal
red blood cells are allowed to persist in the peripheral blood.
True
False
Feedback
After a patient has their spleen removed via a splenectomy, their red blood cells will
no longer be filtered in the same manner. The spleen acts to remove abnormally
shaped red blood cells as well as red blood cells containing inclusions. Without the
spleen, the liver can perform some of the filtering; however, not to the same degree as
the spleen. Therefore, without the spleen, abnormal red blood cells are able to persist
in the peripheral blood.

A 49-year-old male with pneumonia was treated with high-dose intravenous

penicillin. He became jaundiced with yellow sclera. The image on the right is typical
of other fields that were observed on his peripheral blood smear.
Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the
clinician requested a direct antiglobulin test (DAT) be performed. The DAT was
positive, indicating that antibodies to the drug were produced, which then attached to
the drug on the surface of the red cells. Hemolysis occured due to the drug-induced
antibody attachment, leaving the patient with various abnormal red blood cell
morphologies. Which of the following cell types would you report for this patient?
Acanthocytes
Nucleated red blood cells
Target cells
Spherocytes
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In this case, the peripheral blood smear shown should have an associated report that
includes: spherocytes, polychromatophilic cells, and nucleated red blood cells. This
peripheral blood picture is common in patients with drug-induced hemolysis.

Segmented Neutrophil
Band Neutrophil
Eosinophil
Basophil
Red Blood Cell
Platelet
Feedback
This is an eosinophil that has been disrupted by the mechanical process of making the
blood smear.

A 5-year-old girl was brought to the emergency department with bloody diarrhea and
severe abdominal pain. A complete blood count produced these results:
CBC Patient Result Reference Interval

Parameter
WBC 9.6 x 109/L 4.3 - 10.8 x 109/L
Hemoglobin 9.1 g/dL 11.5 - 13.5 g/dL
HCT 28% 37 - 48%
MCV 80 fL 86 - 98 fL
RDW 13.1 11 - 15
Platelets 90.1 x 109/L 150 - 450 x 109/L
The peripheral blood smear is represented in the image to the right. Which of the
following condition(s) could be present in this patient when considering the
information above and the cells indicated by the arrows on the peripheral smear?
Hereditary spherocytosis
Hemolytic uremic syndrome (HUS)
Beta thalassemia
Feedback
The intended response is HUS

Scattered schistocytes and helmet cells are present in HUS. The presence of
polychromatic erythrocytes and scattered spherocytes would also support a hemolytic
process. HUS is usually seen in children; it is the most common cause of acute renal
failure in children. Patients may have bloody diarrhea and symptoms resembling colitis.
Diarrhea-related HUS is usually associated with ingestion of undercooked beef
contaminated with Ecoli O157:H7; it is the Shiga-like toxin from this serotype that causes
the illness.
Spherocytes would appear as the predominate erythrocytes in a case of hereditary

spherocytosis. Hemoglobin is often normal, but infection, fever, and stress can cause
the spleen to destroy more red blood cells. If this had occurred, the hemoglobin would
be low, but the patient would also appear jaundiced due to an increase in bilirubin.

The condition which is highly associated with the oval-macrocytes and

hypersegmented neutrophils found in this image is:
Sideroblastic Anemia
Megaloblastic Anemia
Iron Deficiency Anemia
Malarial Infection
Feedback
The correct response is megaloblastic anemia. A diagnosis of megaloblastic anemia

can be made on the basis of the presence of hypersegmented neutrophils and oval
macrocytes in the blood or of typical megaloblasts in the marrow. These features are
absent in patients with sideroblastic and iron deficiency anemias as well as those with
parasitic malarial infections. In this condition, the macrocytes tend to be round and
oval. Polychromatophilia and reticulocytosis may be prominent as well.

The condition most likely associated with the peripheral blood picture shown in the
image on the right is:
Artifact of staining
Congenital spherocytosis
Autoimmune hemolytic anemia
Feedback
The intended response is iron-deficiency anemia. The red blood cells are microcytic
and hypochromic. Microcytes have pale or hollow centers. In contrast, spherocytes
are solidly stained. Therefore, both congenital spherocytosis and hemolytic anemia
with its spherocytic component are ruled out. Additional studies and complete
medical history and/or repeat smears may be indicated for clarification. Note the
absence of polychromasia in any red cells. This is further evidence of iron deficiency.

Identify the cell in this illustration indicated by the arrow:
Myelocyte
Reactive lymphocyte
Monocyte
Feedback
The segmented neutrophil is generally the most abundant normal WBC seen in the
adult peripheral blood.


A patient with suspected intraabdominal malignancy had a paracentesis performed.
The fluid was then sent to the laboratory for examination and fluid differential. Which
cells predominate in this cytospin field from the patient's sample?
Monocytes
Atypical lymphs
Blasts
Plasma cells
Tumor
Feedback
The predominant cells in this image are plasma cells. This patient may have been
suffering from a plasma cell malignancy in the abdominal cavity, hence the presence
of numerous plasma cells in the peritoneal fluid.


What are the cells that are indicated by the arrows in this peripheral blood smear
image?
Echinocytes
Elliptocytes
Spherocytes
Stomatocytes
Feedback
The cells indicated by the arrows in the image are spherocytes. Spherocytes have a
decreased surface to volume ratio and are therefore smaller with an increased MCHC.
Spherocytes have lost their bi-concave shape and are spherical in shape, hence the
name.


The red blood cells pictured here are morphologically normal.
True
False
Feedback
The red blood cells depicted in this image display both normal size and hemoglobin
content. These cells would be described as normocytic, normochromic.

CSF Sample Shows Tumor Cells

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CSF Sample Shows Tumor Cells

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You answered the question incorrectly.

The correct answer is highlighted below

This is a cytospin from the CSF of a patient with disseminated retinoblastoma

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The correct answer is highlighted below

Cell "b" = neutrophil

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You answered the question incorrectly.

The correct answer is highlighted below

You answered the question incorrectly.

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The presence of scattered normoblasts and myelocytes in the peripheral blood

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Sickle cell disease

Cells seen here are sickle cells or drepanocytes.

Question Difficulty: Level 2

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Question Difficulty: Level 9

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Hypersegmentation of the nucleus

The morphology indicated by the cell in this image is hyposegmentation. This

Question Difficulty: Level 6

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The correct answers are highlighted below

Nucleated red blood cells

The correct answer is highlighted below

You answered the question incorrectly.

The correct answer is highlighted below

You answered the question incorrectly.

The correct answer is highlighted below

This multinucleate giant cell is a histocyte.

You answered the question correctly.

This Prussian Blue stain shows a ringed sideroblast.

The correct answer is highlighted below

A ten-year-old boy came to a physician's attention because of recent jaundice and

The correct answer is highlighted below

You answered the question correctly.

What is the best description of the phenomenon seen in this illustration?

The correct answer is highlighted below

Question Difficulty: Level 4

You answered the question incorrectly.

The correct answer is highlighted below

The intended response is postsplenectomy syndrome. The red blood cell

You answered the question correctly.

The correct answer is highlighted below

The intended response is false.

This is a monocyte with prominent cytoplasmic vacuoles, characteristically seen in a

You answered the question correctly.

The correct answer is highlighted below

Cabot rings may be found in megaloblastic anemias, thalassemia, and following

You answered the question correctly.

The cell indicated by the arrow in this illustration is called:

You answered the question incorrectly.

The correct answer is highlighted below

Sickle cell anemia

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The correct answers are highlighted below

Question Difficulty: Level 7