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How I investigate difficult cells at the optical microscope.

Gina Zini1

  • 1Fondazione Policlinico Universitario A. Gemelli IRCCS - Roma, Università Cattolica del Sacro Cuore, Rome, Italy.

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Morphological identification of blood cells is crucial for diagnosing hematological neoplasms. This review focuses on identifying challenging cells with significant diagnostic implications in peripheral blood and bone marrow.

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Area of Science:

  • Hematology
  • Pathology
  • Cell Biology

Background:

  • Blood cell morphology is fundamental for diagnosing hematological neoplasms, complementing other diagnostic methods.
  • Despite advancements like the WHO classification, morphological analysis faces challenges with standardization and interobserver variability.
  • Key diagnostic aspects include counting blasts and identifying dysplastic cells.

Purpose of the Study:

  • To review methods for identifying difficult-to-diagnose blood cells.
  • To highlight cells with significant diagnostic implications in hematological neoplasms.
  • To provide guidance for improving morphological diagnostic accuracy.

Main Methods:

  • Literature review of morphological classification systems (e.g., FAB, WHO).
  • Analysis of diagnostic criteria for challenging cell identification.
  • Focus on peripheral blood and bone marrow film analysis.

Main Results:

  • Detailed descriptions of various hematological neoplasms based on morphology.
  • Identification of specific cell types and morphological features critical for diagnosis.
  • Discussion of common pitfalls and variability in morphological assessment.

Conclusions:

  • Morphological assessment remains a vital component in diagnosing hematological neoplasms.
  • Accurate identification of difficult cells enhances diagnostic precision.
  • Standardization and continued education are essential for improving interobserver agreement.