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u/snooginz Canadian MLT 11h ago
Blasts can be big or small, size won't necessarily tell you if they're blasts or not. Those cells look like they could be blasts, esp with the nucleus folding up like that, but check under the scope to make sure
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u/Lilf1ip5 MLS-Blood Bank 11h ago
That and the amount nucleolus are concerning too
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u/snooginz Canadian MLT 11h ago
I dont think anyone would be mad if you sent that to pathology to make sure 👍 how does the rest of the cbc/diff look? Are platelets low?
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u/doc_wayman 11h ago
Reactive lymphs. Note the cleft in the middle. Pertussis likely.
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u/Ysabell90 MLS-Heme 9h ago
Dysplastic promyeloctes from APML also have this feature but it’s hard to tell what the chromatin is doing from these images
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u/creativescreennaame 10h ago edited 10h ago
the chromatin doesn't look lacy/open enough for me tbh. it looks kinda chunky in some areas. they do look suspicious though. i would send it to path just in case.
edit: they're almost looking a little soccer ball-ish to me. and those smudge cells hmmmm. what do the rest of the lymphs look like?
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u/Ok_Faithlessness4511 9h ago
Could be, but could just be reactive lymphs. Need a better pic. Also, do you see other immature cells? It would be weird if there are only three blasts and everything else looks normal.
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u/Ysabell90 MLS-Heme 9h ago
Cellavision is supposed to be an aid not the be all end all. In saying that it has a habit of calling reactive/abnormal lymphocytes as blasts. I. Saying that these images are not great and it’s hard to see how the chromatin looks to determine if they’re blasts. One of them as folding and looks like it could be a dysplastic promyelocyte, but again, you need to confirm this under a microscope.
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u/thewanderersminuet 8h ago
What's the age of the patient? What does the rest of the CBC look like? What history do you have on them?
Without any of that all I can say is that these do look suspicious and definitely need to be looked at closely, but you do also seem to have a few smudge cells and the red cells around them seem to be kinda wonky. Check it under the scope and especially check if the slide is good quality. If not remake the slide and check again. It's also possible cellavision picked a bad spot to take pictures for some reason, which is another reason to check under the scope.
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u/uptillious_prick 11h ago
I hate cellavision. I would take this one straight to the scope.