Common Morphological terms used when reporting Blood Films:
Red Cells Morphology
| Anisocytosis | i.e. variation in size |
| anaemia responding to treatment | |
| post transfusion | |
| Dimorphic picture | i.e. two populations of red cells |
| anaemia responding to treatment | |
| post transfusion | |
| Poikilocytosis | i.e. variation in shape |
| teardrop cells may suggest marrow fibrosis | |
| Pencil cells | Consider iron deficiency |
| Spherocytes | Consider haemolysis |
| Target cells | Consider liver disease, splenectomy, haemoglobin C, thalassaemia |
| Macrocytosis | Consider liver disease, excess alcohol, vitamin B12 and / or folate deficiency |
| Howell-Jolly bodies | lack of spleen, splenic atrophy |
| Microcytosis | Consider iron deficiency, thalassaemia |
| Hypochromia | Consider iron deficiency, thalassaemia |
| Red cell fragments | Consider disseminated intravascular coagulation |
| Polychromasia | Indicates reticulocytosis |
| response to bleeding, haemolysis or haematinics |
White Cells Morphology
| Neutrophil leucocytosis (neutrophilia) | A normal finding in pregnancy |
| Consider bacterial infection, inflammation, neoplasm, steroid treatment | |
| Hypersegmented (right shifted) neutrophils | Consider vitamin B12 and / or folate deficiency |
| Left shifted neutrophils | Consider bacterial infection (often with toxic granulation), myelodysplasia |
| Neutropenia | Can be a normal variant, especially in Afro-Caribbeans |
| Consider B12 and / or folate deficiency, auto-immune disease, drugs (especially chemotherapy) | |
| Lymphocytosis | Normal in children |
| Consider viral infection, infectious mononucleosis, pertussis, TB, chronic lymphocytic leukaemia (smear cells typically present) | |
| Eosinophilia | Consider allergic reaction, parasitic infection |
| Monocytosis | Consider bacterial infection |
Platelets Morphology
| Reduced | Consider marrow failure, ITP (typically with platelet anisocytosis and large platelets), drug therapy |
| Increased | Response to bleeding, inflammation, neoplasm, infection. If persistent consider myeloproliferative disease |
Analyser equipment in use across the BCP includes:
- Sysmex CT-90 Track System
- Sysmex XN FBC Analysers (FBC’s)
- Sysmex SP Stainer’s (PBF’s)
- Sysmex DI‐60 Digital Morphology (PBF’s)
- Starrsed RL & ST ESR Analysers (ESR’s)
- IL ACL Tops 550 & 350 Coagulation Analysers (All Coag tests)
- Tosoh G11 Analyser (HBOP)
The laboratories across the Black Country Pathology Service have the capacity to process over 1500 Full Blood Counts per hour and provides haematology testing to a population of just under one million people.
