New York State Department of Health - Wadsworth Center - Cytohematology Proficiency Testing

Slide 032 [100X]

This slide was taken from the same specimen as Slide 031. The peripheral blood smear was made from a 42 year-old female seen by her physician for a routine annual examination. She was asymptomatic. Her white blood cell count was 152.6 X 10³/µL. The differential showed 2% blasts among other immature cells of the neutrophilic series. Diagnosis was chronic myelogenous leukemia (CML). The cell indicated by the arrow on slide 032 is a myeloblast. Responses of blast cell present not classified, myeloblast and promyelocyte were accepted for slide 032. The cell did contain a few non-specific azurophilic granules. According to Diagnostic Hematology Clinical and Technical Principles by Lawrence W. Powers, "...a myeloblast can be distinguished from a promyelocyte by its lack of cytoplasmic granulation, although some workers reserve the use of myeloblast for cells that contain a few fine azurophilic granules." Therefore, because the blast contained a few fine granules, the response of promyelocyte was also accepted. A clinical chemistry profile was unremarkable except for an LDH of 840 U/L. Normal range for the laboratory submitting this case was 118-242 U/L.

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