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血液抹片V1
血液抹片V1
血液抹片V1
血液抹片判讀的注意事項
為何而拉 ?
大小
顏色
內容物
RBC
WBC
Platelet
為何而拉 > 要先有診斷 !!
Cytopenia
MDS: hypersegment, hypolobulation, blast
Nutrition deficiency: hypersegment, microcystic, hypochromatic
Cytosis
MPN: tear drop
Leukemia: blast
Morphology
Leukemia: blast, immature cell
MAHA: fragment RBC
Congenital RBC disease: sickle cell, sphrenocyte
VS
紅血球篇
Erythroblast/nucleated RBC
Immature RBC in PB
Large blood loss
Destruction of bone marrow
barrier
白血球篇
Lymphocyte
High N/C ratio
Dense nuclear
Size near RBC-> good reference
for RBC size mearsurement
Metamylocyte
Immature cell
Reactive of infection,
inflammation
G-CSF effect
Myeloid neoplasm: CML
Promylocyte
Immature cell with nucleolus
Reactive change
Special disease
Blast
Immature cell with nucleolus
Leukemia
MDS
PMF
Reactive lymphocyte
Reactive for infection or
inflammation
No nucleolus
Viral infection
Autoimmune disease
Blast? Reactive lymphocyte?
Pelgeroid cell(hypolobulation)
Dysplasia picture
MDS!!!
Hypersegment WBC
DNA instability of WBC
Aucte infection
Blast > APL
G-CSF effect
血小板篇
Gaint platelet
Fresh platelet
CBC:
WBC: 24000
HB: 8.2
Plt: 12000
CMMoL
MDS+MPN
106 年內專
CBC:
HB: 6.3
Reti: 3.5%
Bil(T/D): 3.4/0.7
Thalassemia
107 年內專
CBC:
WBC: 130810
HB: 10.5
Plt: 47000
CML
107 年內專
CBC:
WBC: 8500
HB: 7.5
Plt: 11000
Reti: 5.4%
Bil(T/D): 3.1/0.7
Con’s change
LDH: 1350
Crea: 1.1
PT/aPTT: normal
MAHA(TTP)
108 年內專
APL
感謝可愛的工作細胞們 ~
Thank you!