Blood Cell Identification Master List

Note: Please read the history that accompanies the photographs before making your selection. If microorganisms, inclusions, or other intracellular findings are seen, choose an identification that indicates their presence.

108 Immature or abnormal cell, would refer for identification (Code 122 Neutrophil with hypersegmented nucleus 108 should be used only if you would routinely send the cell in 240 Neutrophil with Pelger-Huët nucleus (acquired or question to an outside laboratory with another CLIA number.) congenital)

Erythrocytic Cells, Inclusions, and Morphology Lymphocytic and Plasmacytic Cells 140 (spur cell) 265 Lymphocyte 152 (coarse) 307 Lymphocyte, large granular 245 Bite cell 266 Lymphocyte, reactive (to include plasmacytoid and immunoblastic 299 Blister cell/Prekeratocyte forms) 287 (burr cell, crenated cell) 162 Lymphoma cell (malignant) 135 Erythrocyte, normal 224 , abnormal 279 Erythrocyte with overlying platelet 223 Plasma cell, morphologically mature 288 Fragmented red cell (, helmet cell, keratocyte, 267 Plasma cell with inclusion (eg, Dutcher body, Russell body, etc) triangular cell) 153 Hemoglobin C crystal Megakaryocytic Cells and Platelets 155 Howell Jolly body (Wright stain) 279 Erythrocyte with overlying platelet 229 Macrocyte oval or round (excluding polychromatophilic red cells) 212 Megakaryocytic cell (normal, abnormal, or nuclear fragment) 249 Microcyte (with central pallor) 263 Platelet, giant 253 Nucleated red cell, normal or abnormal morphology 285 Platelet, hypogranular 146 Ovalocyte () 171 Platelet, normal 157 (iron stain) 264 Platelet satellitism 225 Pappenheimer bodies, presumptive (Wright stain) 134 Polychromatophilic (non-nucleated) red cell Microorganisms 178 Red cell agglutinates 282 Babesia 188 268 Bacteria (cocci or rod), extracellular 147 Sickle cell (drepanocyte) 269 Bacteria (spirochete), extracellular 148 Spherocyte 270 Fungi, extracellular 149 Stomatocyte 196 Leukocyte with Anaplasma/Ehrlichia 150 Target cell () 271 Leukocyte with phagocytized bacteria 151 Teardrop cell (dacrocyte) 231 Leukocyte with phagocytized fungi 283 Microfilaria RBC Morphology (for VPBS and EHE Surveys only) 156 Plasmodium sp. (malaria) 296 233 Protozoan (non-malarial) 298 Hypochromasia 311 Parasite(s) seen, referred for definitive identification. (Code 131 294 should be used only if you would routinely send cell in question to an outside laboratory with another CLIA number.) Myeloid: Granulocytic and Monocytic Cells 208 Basophil, any stage Miscellaneous 209 Eosinophil, any stage 118 Alder anomaly inclusion 236 Monocyte 174 Blast cell 237 Monocyte, immature (promonocyte, monoblast) 119 Chediak-Higashi anomaly inclusion 246 with 200 Cryoglobulin 121 Neutrophil, giant band or giant metamyelocyte 117 Mast cell 112 Neutrophil, metamyelocyte 184 Metastatic tumor cell or tumor cell clump 111 Neutrophil, myelocyte 204 Mitotic figure 191 Neutrophil, necrobiosis (degenerated neutrophil) 246 Myeloblast with Auer rod 161 Neutrophil, polyploid 213 Squamous epithelial cell/endothelial cell 241 Neutrophil, promyelocyte 238 Neutrophil, promyelocyte, abnormal with/without Auer rod(s) Artifacts 284 Neutrophil, segmented or band 192 Basket cell/smudge cell 259 Neutrophil, toxic (to include and/or Döhle 279 Erythrocyte with overlying platelet bodies, and/or toxic vacuolization) 191 Neutrophil necrobiosis (degenerated neutrophil) 239 Neutrophil with dysplastic nucleus and/or hypogranular 220 Stain precipitate cytoplasm

Customer Contact Center 800-323-4040 option 1 (domestic), or 847-832-7000 option 1 (international) 3 VPBS-A *2525613980102* 2012 KIT 25256139 8 01 02

CAP # 1255901 - 03 SEQ # 01 Page 1 Results must be received at the CAP no later than Products: VPBS midnight, Central Time by the due date below: STONY BROOK UNIVERSITY MEDICAL CENTER NANCY YEN TEL# 631-444-2600 FAX# 631-444-2653

Virtual Peripheral Blood Smear Survey Result Form © CAP 2012

VPBS-01 Case History ! To display the online images, select the View Image link on the result form details page.

VPBS-A 01: This peripheral blood smear is from a 54-year-old female with shortness of breath and lethargy, one week status post a viral syndrome, brought to the Emergency Room by her husband. Laboratory data include: WBC = 19.8 109 /L; Hb = 11.5 g/dL; MCV = 95 fl; MCHC = 35.5 gm/dL; RDW = 15.5 %; and PLT = 20 x109 /L; Creatinine = 8.5 mg/dL; BUN = 115 mg/dL. Identify the arrowed object(s) in each image.

(PERIPHERAL BLOOD, WRIGHT-GIEMSA)

WBC Differential - % VPBS-01 Exception Exception Cell Classifications VPBS-01 Cell Classifications VPBS-01 Code Code 010 11 020 150 11 160 Neutrophils (segs or bands) Myelocytes 33 . 33 .

030 11 040 170 11 180 Lymphocytes Promyelocytes 33 . 33 .

050 11 060 190 11 200 Lymphocytes, reactive Blasts 33 . 33 .

070 11 080 Other Monocytes 33 . (all cells not listed and cells not differentiated by your lab 210 11 220 into the categories listed 33 . above [eg, lymphoma cells]) 090 100 Eosinophils 11 If it is your laboratory's 33 . protocol to note "Other cells" you may do so on the Use of Other form.

110 11 120 230 11 240 Basophils nRBC/100 WBC 33 . 33 .

260 101 Decreased 130 11 140 250 11 Metamyelocytes Platelet Estimate 33 . 102 Adequate/normal 33 103 Increased

33416 Customer Contact Center 800-323-4040 option 1 (domestic), or 847-832-7000 option 1 (international) APN1 VPBS-A *2525613980245* 2012 KIT 25256139 8 02 45

CAP # 1255901 - 03 SEQ # 01 Page 2 Results must be received at the CAP no later than Products: VPBS midnight, Central Time by the due date below: STONY BROOK UNIVERSITY MEDICAL CENTER NANCY YEN

Red Cell Morphology VPBS-01 Identification code

010 020 030 040

Cell Identification ! To display the online images, select the View Image link on the result form details page. Exception Code VPBS-02 VPBS-03 VPBS-04 VPBS-05 VPBS-06

050 11 060 070 080 090 100 33

VPBS-07 Case History VPBS-A 07: This peripheral blood smear is from a 13-year-old female, with a diagnosis of Sanfilippo syndrome and autism. Laboratory data include: WBC = 3.7 x 109 /L; HGB = 9.4 g/dL; MCV = 91.7 fl; RDW = 12.7 %; PLT = 111 x109 /L. Identify the arrowed object(s) in each image. (PERIPHERAL BLOOD, WRIGHT-GIEMSA)

WBC Differential - % VPBS-07 Note change in specimen number. Exception Exception Cell Classifications Code VPBS-07 Cell Classifications Code VPBS-07 110 11 120 250 11 260 Neutrophils (segs or bands) Myelocytes 33 . 33 .

130 11 140 270 11 280 Lymphocytes Promyelocytes 33 . 33 .

150 160 290 300 Lymphocytes, reactive 11 Blasts 11 33 . 33 . Other 170 180 (all cells not listed and cells Monocytes 11 33 . not differentiated by your lab into the categories listed 310 11 320 above [eg, lymphoma cells]). 33 . If it is your laboratory's 190 11 200 Eosinophils protocol to note "Other cells" 33 . you may do so on the Use of Other form.

210 11 220 330 11 340 Basophils nRBC/100 WBC 33 . 33 . 360 101 Decreased 230 11 240 350 11 Metamyelocytes . Platelet Estimate 102 Adequate/normal 33 33 103 Increased 10637 Customer Contact Center 800-323-4040 option 1 (domestic), or 847-832-7000 option 1 (international) APN2 VPBS-A *2525613980388* 2012 KIT 25256139 8 03 88

CAP # 1255901 - 03 SEQ # 01 Page 3 Results must be received at the CAP no later than Products: VPBS midnight, Central Time by the due date below: STONY BROOK UNIVERSITY MEDICAL CENTER NANCY YEN

Red Cell Morphology VPBS-07

Identification code 010 020 030 040

Cell Identification ! To display the online images, select the View Image link on the result form details page. Exception Code VPBS-08 VPBS-09 VPBS-10 VPBS-11 VPBS-12

050 11 060 070 080 090 100 33

9708 Customer Contact Center 800-323-4040 option 1 (domestic), or 847-832-7000 option 1 (international) APN3 *2525613980421*

KIT 25256139 8 04 21

CAP # 1255901 - 03 SEQ # 01 Page 4 Products: VPBS STONY BROOK UNIVERSITY MEDICAL CENTER NANCY YEN

Attestation/Use of Other Form Attestation Statement

 As stated in the February 28, 1992 Federal Register under Subpart H 493-801 (b) (1), “the individual testing or examining the samples and the laboratory director must attest to the routine integration of the samples into the patient work load using the laboratory's routine methods.” The laboratory director or designee and the testing personnel must sign on the result form.  Retain a signed copy of this page in your laboratory for your records and inspection purposes.

We the undersigned, recognizing that some special handling may be required due to the nature of Proficiency Testing (PT) materials, have as closely as is practical, performed the analyses on these specimens in the same manner as regular patient specimens. We confirm that results were not shared or PT specimens referred or tested outside our CLIA identification number.

Director 010 Survey 030 (or Designee) (Shipment)

Testing Testing Testing Personnel Personnel Personnel 040 090 140

Use of Other This section is provided to list methodology information not found on master lists. For online entry, you can enter only 255 characters. LAP Customers: Do not use this section to indicate test menu changes. Download the LAP Test Menu Change form at www.cap.org and fax or mail it to the CAP. 190

Signatures will not display when viewed online. 58889 Customer Contact Center 800-323-4040 option 1 (domestic), or 847-832-7000 option 1 (international) AO