Cellular Morphologic Analysis of Peripheral Blood

The peripheral blood smear is a unique diagnostic tool in the hematology laboratory. To maximize its clinical utility requires an orderly approach and an inquiring mind. The first requirement is a protocol that determines when a peripheral blood smear needs to be made and examined. The second is a well-made and well-stained peripheral blood smear devoid of artifacts. The ability to recognize spurious results, whether from the automated analyzer or the slide itself, and to comprehend the reasons for them is essential. Another essential is an understanding of the limitations of smear review with regard to diagnostic certainty. Although many clinical interpretations may be possible based on a particular finding on a blood film, the issues are whether the microscopist can be certain and which findings signify a definitive diagnosis Even in this molecular age, examination and analysis of the peripheral blood smear remains crucial to optimum clinical care.