Evaluation of an automated digital imaging system, Nextslide Digital Review Network, for examination of peripheral blood smears.

CONTEXT: Several automated digital imaging systems have been introduced in recent years to improve turnaround time and proficiency in examining peripheral blood smears in hematology laboratories. OBJECTIVE: To evaluate a new automated digital imaging system, Nextslide Digital Review Network (Nextslide), for examination of peripheral blood smears. DESIGN: We evaluated 479 peripheral blood smears, of which 247 (51.6%) were included for comparison of Nextslide and manual white blood cell differential counts and morphology evaluation, 204 (42.6%) were included for comparison of Nextslide and CellaVision (DM96) differential counts, and 28 (5.8%) were neonatal samples examined for enumeration of nucleated red blood cells. RESULTS: Results from both method comparisons showed excellent correlation for all major white blood cell classes with correlation coefficients ranging from 0.70 to 0.99. Evaluation of white blood cell, red blood cell, and platelet morphology also showed good correlation among methods. White blood cell preclassification capability in the system was evaluated for rate and accuracy. Leukopenic samples demonstrated markedly decreased review time with Nextslide. Enumeration of nucleated red blood cells showed good correlation among methods. CONCLUSIONS: Our evaluation of Nextslide shows excellent correlation when compared with conventional manual differentials and CellaVision (DM96) differentials for evaluation of peripheral blood smears.

Spontaneous hepatic hemorrhage secondary to prolonged use of oral contraceptives.

Oral contraceptive pills (OCP) are the most commonly used form of contraception throughout the United States of America. The prolonged usage of oral contraceptives leads to a variety of complications, ranging from subclinical modifications of liver function tests to the development of benign and malignant tumors of the liver. Spontaneous hepatic hemorrhage secondary to oral contraceptive use was only reported once in the early 1980s. We report a case of spontaneous hepatic hemorrhage secondary to prolonged ingestion of combined OCPs followed by multiple pulmonary emboli without underlying thrombophilia.

Chronic basophilic leukemia: a rare form of chronic myeloproliferative neoplasm.

Chronic basophilic leukemia is a rare and poorly characterized entity. Only a limited number of cases have been described. Herein, we report a patient who presented with fatigue, weight loss, leukocytosis, persistent prominent basophilia, and mild eosinophilia. The bone marrow showed features characteristic of a myeloproliferative neoplasm with a marked increase in maturing basophils. The basophils exhibited nuclear hypersegmentation, abnormal granulation, and abnormally low CD38 expression. Conventional karyotyping revealed a t(5;12)(q31;p13). ETV6 but not PDGFRB rearrangement was detected by fluorescence in situ hybridization.