Overview
Pattern lookup for smear and marrow reviewers, extends Module 4 normal marrow baseline.
Classification
| Finding | PB/BM | Pattern association (not exclusive) | Typical next reflex |
|---|---|---|---|
| Blasts ≥ institutional threshold | PB and/or BM | Acute leukemia among associations | Marrow, flow, cytogenetics |
| Auer rods | PB | AML among associations | Flow myeloid markers |
| Smudge cells | PB | CLL among associations | Flow clonal B-cell |
| Dysplastic granulocytes | PB/BM | MDS among associations | Marrow, cytogenetics |
| Teardrop cells + NRBCs | PB | Marrow fibrosis/infiltration among associations | Marrow biopsy, molecular |
| Rouleaux | PB | Paraprotein among associations | SPEP/IFE, FLC |
| Hypercellular marrow + granulocytic proliferation | BM | MPN/CML among associations | BCR-ABL1, JAK2 panel |
| Plasma cell infiltrate | BM | Plasma cell neoplasm among associations | SPEP, marrow quantitation |
Morphologic Features
Cross-link Module 6 abnormal-white-cell-morphology, do not duplicate teaching narrative.
Laboratory Characteristics
- Quantify blasts when reported on differential
Reference Intervals
Blast reporting thresholds per institutional policy.
Clinical and Laboratory Significance
Patterns suggest workup direction, not final diagnosis.
Differential Considerations
Reactive dysplasia, regenerative left shift, viral lymphocytosis among mimics.
Comparison Tables
Classification Frameworks
Laboratory Notes
- Staged cases in Challenge Center practice PB → smear → ancillary interpretation.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- Arber DA, Orazi A, Hasserjian RP, et al. Atlas of Diagnostic Hematology. 4th ed. Elsevier; 2023.
- Bain BJ. Blood Cells: A Practical Guide. 6th ed. Wiley-Blackwell; 2022.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
- Hoffbrand AV, Moss PAH, Pettit JE. Essential Haematology. 8th ed. Wiley-Blackwell; 2019.
CLSI and Professional Guidelines
- International Consensus Classification of Myeloid Neoplasms and Acute Leukemias (ICC). Blood. 2022;140(11):1200–1228.
WHO Publications
- World Health Organization. WHO Classification of Haematolymphoid Tumours. 5th ed. Volume 11. Lyon: IARC Press; 2024.
Frequently Asked Questions
Common questions about using this Malignancy PB and BM Finding Patterns foundational topics Medical Laboratory Library reference in Medical Laboratory Science education.
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