Hematology Case Studies Answers

A 60-year-old female with autoimmune hemolytic anemia came in for a pre-surgical work up. The CBC results were as follows:

WBC: 4.81 x 109/L
RBC: 1.88 x1012/L
HGB: 12.6 g/dL
HCT: 36.7 %
MCV: 195.2 fl
MCH: 67.0 pg
MCHC: 34.3 g/dL
PLT: 215 x109/L

Automated Differential

Segs: 51.8 %
Lymph: 36.8 %
Mono: 6.4 %
Eos: 4.6 %
Baso: 0.4%

• What abnormalities are seen in the CBC results?
• What abnormality is seen on the differential slides ?
• What is the cause of the illogical values in the CBC results?
• How would you treat the sample to get correct results ?

A 34 year old female came in for a wellness screen; the following are her CBC results:

WBC: 5.7 x109/L
RBC: 4.61 x 1012/L
HGB: 14.9 g/dL
HCT: 42.8 %
MCV: 92.8 fl
MCH: 32.3 pg
MCHC: 33.9 g/dL
PLT: 2 x 109/L

Automated Differential:

Segs: 72.3
Lymph: 14.5
Mono: 6.3
Eos: 4.3
Baso: 2.6

• Are there any abnormalities on the CBC ?
• What abnormality is seen on the differential slide ?
• How would you report the parameter in question?

A 50 year old male had his pre-op work done for a total knee; the following are his CBC results:

WBC: 8.7 x109/L
RBC: 4.91 x 1012/L
HGB: 15.9 g/dL
HCT: 47.8 %
MCV: 97.3 fl
MCH: 32.3 pg
MCHC: 33.3 g/dL
PLT: 20 x 109/L

Automated Differential:

Segs: 75.3 %
Lymph: 18.5 %
Mono: 2.3 %
Eos: 2.3 %
Baso : 1.6 %

Due to the low PLt count the slide was scanned an numerous platelet clumps were noted.

• How would you handle this specimen to get an accurate platelet count ?

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