Plain Talk about A Blood Smear Review From the Pathologist’s Perspective

Did you know that reviewing a blood smear can determine a patient’s blood cell disease in many instances prior to a bone marrow biopsy?  A bone marrow biopsy can be extremely painful, and often times may not be necessary.  A bone marrow biopsy is typically indicated to either confirm the changes seen on blood smear such as various types of anemia/erythrocytosis, leukopenia/leukocytosis, thrombocytopenia/thrombocytosis, or to resolve fever of unknown origin, or to determine stages of certain cancer and confirm a diagnosis of leukemia, myeloma, and/or lymphoma.

Red blood cells, white blood cells, and platelets are blood cells that are principally produced in the bone marrow during adulthood.  Each one of these blood elements carries out a specific function in maintaining balance in human organ systems (homeostasis); and a simple review of an anatomy and physiology text book can point out the specific functions of these blood elements.

The purpose of a peripheral smear review is to assess the following:

1. Production of blood cell elements

2. Destruction and/or loss of blood cell elements

3. Blood cell tumor or atypical forms.

The above three levels of investigation examine specific numbers of blood cells, as well as specific types/forms, in addition to  their various shapes and sizes to determine the types of blood cell diseases.

Often times, simply reviewing a blood smear review coupled with a complete history and physical examination can determine specific types of anemia, or other blood cell diseases.  Blood cell smear review is coupled with an objective test known as Complete Blood Count Report (CBC).  Taken together, the CBC report and a blood cell smear review, may determine whether or not a bone marrow biopsy is necessary. A blood smear review only requires collecting a sample in a lavender-colored top test tube, and then taking an aliquot (droplet) of the sample to smear onto a glass slide, allowing the slide to dry, and then staining the slide with a simple blue-dye, which from start to finish takes about 10-15 minutes, and costs the patient around 65 dollars for a final diagnostic interpretation by Dr. Gates. This evaluation will also include a complete blood count report with a differential count-CBC with differential (generated by an automated laboratory analyzer at our reference clinical laboratory affiliate).

MDC-Atlanta remains committed to informing our patients for better quality and safe medical care.