From the Guidelines
A peripheral blood smear should be reviewed for the presence of mast cells and/or evidence of an associated hematologic neoplasm, as recommended by the NCCN clinical practice guidelines in oncology 1. The peripheral blood smear is a crucial diagnostic tool that provides valuable information about the presence of mast cells, dysplasia, monocytosis, and/or eosinophilia in patients with suspected mast cell diseases.
- The test involves examining the appearance of blood cells under a microscope, which helps identify specific cell morphologies associated with different diseases.
- The procedure requires a small blood sample, typically drawn from a vein in the arm, and results are usually available within hours to a day.
- According to the ASCO clinical practice guideline endorsement of the College of American Pathologists and American Society of Hematology guideline, a pathologist should review recent or concurrent CBC counts and leukocyte differentials and evaluate a peripheral blood smear 1.
- The percentage of circulating mast cells should be reported in patients with mast cell leukemia, and the smear should be reviewed for features of an associated hematologic neoplasm.
- The value of a peripheral blood smear lies in its ability to provide visual confirmation of abnormalities that automated analyzers might miss, allowing clinicians to identify specific cell morphologies associated with different diseases.
- For accurate interpretation, the smear should be prepared properly and examined by trained laboratory professionals or hematologists.
From the Research
Purpose of Peripheral Blood Smear
- A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a number of circumstances and for a variety of reasons 2
- The Peripheral Blood Smear (PBS) examination plays an important role in evaluating hematological disorders, such as anemia 3
- Peripheral blood smear examination is used to diagnose and evaluate suspected platelet-related disorders in children 4
Analysis of Peripheral Blood Smear
- Manual analysis of peripheral blood smear is tedious, time-consuming, and prone to errors, requiring qualified laboratorians 3, 5
- Automation of PBS analysis is an active field of research, with methods using image processing techniques being developed 3, 5
- Image analysis consists of a sequence of steps, including image segmentation, features extraction and selection, and pattern classification 5
Applications of Peripheral Blood Smear
- Anemia diagnosis using PBS 3
- Evaluation of suspected platelet-related disorders in children 4
- Verification of flagged automated hematology results and determination of the need for a manual differential leukocyte count 2
- Provision of a complete hematologic picture of a case, including diagnosis or diagnostic clues 2