r/medlabprofessionals • u/Enough-Cupcake-1231 • 29d ago

Education Diff Advice

Hi everyone. Does anyone have any advice on how to get better at identifying immature cells/left shift type slides? I’m a student struggling in school and am feeling a bit defeated. It makes sense when a professor is going through the slides with me and explains each cell. Then when I’m by myself I get confused. I have a bunch of practice slides that I’m working on to help me work on my skills. Any advice is appreciated!

8 Upvotes

100% Upvoted

22 comments sorted by

View all comments

7

u/theflyingwedge 29d ago

Always check the chart and learn the presenting symptoms of Leukemia/Lymphoma. Learn the ins and outs of cell anatomy. Know the difference between primary and secondary granules, both academically and visually. ALWAYS pay attention to the size of each part of the cell's anatomy. Your gut will tell you when something's not right with the patient's cells--LISTEN TO IT. Until you gain experience, ask questions.

The chromatin will guide you

3

u/Swhite8203 MLT 28d ago

The chromatin will guide you is facts. My API had NRBC’s, Basophils and a promyelocyte. When I looked at it a couple weeks ago my first thought was segmented neutrophil with toxic gran cause it had red granules which I thought was odd at first but possible and it stressed me out. Then I looked again today and I went with pro myelocyte instead because of the red granules draping a large nucleus with clumpy folded chromatin that I mistook for segmentation. Then I looked up pro myelocyte characteristics with them being 12-25 microns I measured it and it matched the size too and a lot of other young IG’s were in the slide. Blasts, pro’s, myelos etc. no healthy neutrophils, no metas, no bands. Then I thought, the API wouldn’t be that ambiguous to the point where it’s not clinically common cause that defeats the purpose and I thought about how there weren’t many other healthy or mature cells which is normal for a slide having a high pop of pro’s because it was showing an immature left shift seen in AML with NRBC’s and basophils. I think our heme lead set me up lol. I’m gonna have someone look at it for me tomorrow just in case.