Metamyelocyte

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

Slide 102 [100X]  

The patient is a 52 year-old male with a history of chronic myelogenous leukemia (CML), admitted with leg ulcers. Similar to the first case, the white cell count was elevated (14.5 x 109 / L) and the red cell parameters were reduced (RBC 2.85 x 1012 / L; hemoglobin 9.3 G / dL; and hematocrit 28.2%). The arrowed cell is a metamyelocyte (code: 07). While the nuclear:chromatin ratio is close, the nucleus is indented to less than half the nuclear width. The cytoplasm contains primary as well as specific granules. The cell is large in comparison to the adjacent segmented neutrophil. A number of laboratories identified the cell as a band neutrophil. Because of the closeness of the ratio of indentation to nuclear circumference, band neutrophil (code 08) is also an acceptable response.

 

Number of Responses

% of Laboratories

Cell Code and Type

342

74.5

Code: 07     Metamyelocyte

106

23.1

Code: 08     Band neutrophil

7

1.5

Code: 13      Eosinophil

1

0.2

Code:  01     Blast cell, not classified

1

0.2

Code:  05     Promyelocyte

1

0.2

Code:  06     Myelocyte

1

0.2

Code:  12     Monocyte

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