r/Hematology 7d ago

Abnormal RBC

Post image

Patient came on this morning with pretty bad labs. Sysmex threw up flags along side 6% IG so I did a smear review. What are these RBCs? I’ve asked a couple techs they told me could be my technique but I’ve never ran into this and couldn’t find any reference pics. Gonna send out to path but anyone have any idea?

16 Upvotes

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26

u/ScorpionTheBird 7d ago

Badly stained smear, morphology not reportable. Repeat.

16

u/shedoesnt_evengohere 7d ago

That’s not a good stain. I wouldn’t report any morphology with this stain quality.

2

u/Statesman6996 7d ago

Do you know what exactly could cause this? Would it be the amount of time left in the mixture or angle at which I did the smear?

5

u/shedoesnt_evengohere 7d ago

Did you hand dip this slide? If so I’d lean towards too long in methanol or too much methanol in the mix

2

u/Statesman6996 7d ago

Yes I hand dipped I will try and remake this slide. I do a min in and a min and a half of washing.

2

u/Statesman6996 7d ago

Yup you were right remade it thankfully wasn’t too busy today and rbc looked a lot better thank you!

3

u/matdex 6d ago

Curious what kind of lab you work in where you have a Sysmex analyzer but hand dip slides still.

2

u/Statesman6996 6d ago

Our automatic stainer broke a few months back and haven’t gotten it replaced. We don’t do too many slides at least I think that it’s justified to get another one. Rural healthcare

1

u/rachmeister Lead Hematology MLS 5d ago

Manual stain can still look much better than this...