Peripheral Blood Film (2025-11-17)
Sources
Peripheral Blood Film (PBF) — 2025-11-17
Lab: KIMS Health Laboratory Medicine, Trivandrum
Bill No: L084158325
Method: MGG stain
Referring Physician: Dr. Mithun Padmanabhan
Pathologist: Dr. Padmini R, MBBS, DNB, MD (Pathology)
Findings
Red Blood Cell
- Anisocytosis, normochromic
- Normocytes and macrocytes present
- Polychromatophilic cells: Few
- Normoblasts: None
White Blood Cell
- Leucopenia: Moderate
- Predominantly neutrophils
- Differential count:
- Neutrophils: 50%
- Lymphocytes: 26%
- Monocytes: 5%
- Eosinophils: 18% (markedly elevated)
- Basophils: 1%
Platelets
- On smear: Decreased
- Seen: Scattered singly
- Giant platelets: Not seen
Haemoparasites
- Not seen
Interpretation
Pancytopenia.
- Moderate anemia with normocytes and macrocytes
- Moderate leukopenia
- Moderate thrombocytopenia
Clinical Context
This PBF was obtained 2 days before the comprehensive DDRC Agilus workup (Peripheral Smear 2025 11 19). Both smears show consistent findings:
| Feature | KIMS (Nov 17) | DDRC (Nov 19) |
|---|---|---|
| RBC morphology | Normochromic, anisocytosis, macrocytes | Normocytic normochromic |
| Leucopenia | Moderate | Mild (2000–3000/cumm) |
| Eosinophils | 18% | 13% |
| Platelets | Decreased, scattered singly | Decreased (60–80K), occasional giant |
| Haemoparasites | Not seen | Not seen |
| Blasts | Not mentioned | Not seen |
The concordance between the two independent smears strengthens the pre-AML pancytopenia picture. The prominent eosinophilia (18% on KIMS, 13% on DDRC) was a notable finding that initially broadened the differential to include eosinophilic disorders and parasitic infections before the bone marrow biopsy confirmed Aml.
Related Pages
- Peripheral Smear 2025 11 19 — DDRC smear 2 days later
- Pancytopenia — The clinical picture these smears describe
- Aml — Underlying diagnosis confirmed by subsequent BMBx
- Bone Marrow Biopsy 2025 11 20 — BMBx #1, 3 days after this smear
Source: raw/labs/Ishamma T M 12.pdf